National Biotechnology Conference 2009 Preliminary Program - (Page 30) SHORT COURSE APPLICATION For Graduate Students and Postdoctoral Fellows Only The first five applicants per short course will be selected to purchase short course registration for the reduced rate of $50. Reduced fees are not applicable after May 29, 2009. Please print or type. Incomplete forms will not be considered. First Name AAPS Member ID (required) Institution Address City Country Day Phone Fax Email Are you a member of an AAPS Student Chapter? If so, which one? June 21-24, 2009 Washington State Convention and Trade Center Seattle, Washington USA APS093 Last (Family) Name State/Province Postal Code Evening Phone H Yes H No Short Course Selections My top two choices are (rank in order with #1 as your first choice): Thursday, June 25 8:30 am – 5:00 pm Short Course #1: Clinical Pharmacology of Biotherapeutic Properties Short Course #2: Analytical and Bioanalytical Assay Development for Biological Therapeutics Up to five applicants will be selected for each Short Course on a first-come, first-served basis for the reduced rate of $50. Payment Method AAPS does not accept government training forms or purchase orders. Federal Tax ID #521444968 H Check # Payable to AAPS-09NBC (U.S. dollars, drawn on a U.S. bank) H Charge my: H Card Number Expiration Date Card Holder’s Name Authorized Signature Authorized Amount to Charge: $ A reduced registration fee of $50 will be requested upon notification of acceptance. If you also request Continuing Education Credits, an additional $30 fee will apply. Applications are not transferable. H H H H I am also registered for the 2009 AAPS National Biotechnology Conference. H I want to purchase Continuing Education Credits for the Short Course. Register! MAIL or FAX this form to: 2009 NBC Short Course Application Form AAPS Attn: Kate McHugh 2107 Wilson Blvd., Suite 700 Arlington, VA 22201-3042 FX: +1 703-243-5582 The signature of your Dean or Department Chair is required below to certify your full-time status to be eligible for this fee. Signature Date Questions? H If I am not accepted for a reduced fee, charge me for the full rate for the Short Course selected. PH: +1 703-248-4793 EM: registration@aaps.org Deadline: 30 May 11, 2007 2009 AAPS NATIONAL BIOTECHNOLOGY CONFERENCE PRELIMINARY PROGRAM
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