2012 International Region 7 Annual Conference
Sunriver Resort, Sunriver, OR
August 10-12, 2012

Registration Form



Cost:
Region 7 Members: $149 USD
Non-Region 7 APMA Members: $299 USD
Non-APMA Member: $775 USD
All of these fees increase by $50 USD if you register after
June 1st.

The delegate registration fee includes general sessions, course syllabus, continental breakfasts, refreshment breaks, & Gala Banquet.

Gala Banquet, Saturday August 11th- (Guest Fee) $35 USD

Things to know about registration for the annual meeting:

Registration: You have two options for registration: You can fill out this form and then click the submit button to proceed to payment through PayPal using any credit card. You may also fill out this form, print it and then mail it in in with your check made out to "Region 7" c/o Susan Scanlan DPM, PO Box 22368
Seattle, WA  98122  USA

Meals: Continental breakfasts, refreshment breaks and the Gala Banquet are included in your registration. You can bring a guest to the Banquet for a fee of $35.

Registration Dates/Refunds: A late fee of $50 USD will be charged for registrations received after June 1st. Refunds of the registration fees paid, less a $75.00 USD administration fee, will be granted if you decide to cancel your registration. Cancellation must be received in writing at the Region 7 office one month prior to the conference date. No refunds will be granted if postmarked after July 10th or for non-attendance at the conference.

Hotel Reservations: Please contact the hotel directly if you require accommodation and mention “International Region 7” to receive the conference room rate. The rate for double occupancy ranges from $219 and up USD per night, plus applicable taxes. Don't delay as we have to release rooms 60 days out. www.sunriverresort.com

Name (As you would like it to appear on your name tag):

Mailing Address:

City:    State/Prov:    Zip/Post:

Phone:   

ALL REGISTRATIONS WILL BE CONFIRMED BY EMAIL
Email
:


Doctor Registration Fees  
Choose One of the following:      
Region 7 Member: $149 USD $    
Non-Region 7 APMA Member: $299 USD $    
Non-APMA Member: $775 USD $    
Choose all that apply:        
Are you bringing a guest to the Banquet? $35 USD x = $  
Late Fee (after June 1st) $50 USD $  
     
     
TOTAL Fees: $ (please fill in)  
     
** Please write down your total fees - You will need to enter this into PayPal when you pay your fees during the next step.