National Biotechnology Conference 2009 Preliminary Program - (Page 31) REGISTRATION FORM - PAGE 1 APS093 June 21-24, 2009 Washington State Convention and Trade Center Seattle, Washington USA First Name Last (Family) Name Job Title Address City Country Fax Emergency Contact Name State/Province Phone Email Organization Middle Initial Nickname for Badge Instructions • Type or print all information. • Payment must accompany your form for registration to be processed. • Keep a copy of your completed registration form for your records. Member # Postal Code Phone H The information above has changed. H I require special services in accordance with the Americans with Disabilities Act. H New Member H Member Renewal* H Applied or renewed separately for AAPS Membership: Date Sent *Renew only if membership expires before June 30, 2009. If you do not know your expiration date, contact AAPS Member Relations at membership@aaps.org or +1 877-998-AAPS. Primary Section (Check up to two at no additional fee.) • Make any changes directly on the label. Your name will appear on your badge as you indicate. • Group registration is available online only at www.aapspharmaceutica. com/nationalbiotech H Check this box if you do not wish to be included in promotional mailings or faxes from AAPS exhibitors sent prior to the 2009 AAPS National Biotechnology Conference. H APQ – Analysis and Pharmaceutical Quality H BIOTEC – Biotechnology H CPTR – Clinical Pharmacology and Translational Research Spouse/Guest Registration (Additional fee required) Spouse/Guest Name for Badge (name only if registering) H H H H H H DDD – Drug Design and Discovery • All information must be completed in full MSE - Manufacturing Science & Engineering to receive a badge. PPDM – PK/PD and Drug Metabolism FDD - Formulation-Design & Development PPB - Physical Pharmacy & Biopharmaceutics RS – Regulatory Sciences Short Course Registration (Additional fee required) Business Information Primary Job Function (Check one) If registering for a Short Course, indicate below in which course you wish to enroll. Also indicate the appropriate registration fee under Special Events on the following page. Course registration is limited and accepted on a first-come, first-served basis. Thursday, June 25 Short Course #1: Clinical Pharmacology of Biotherapeutic Properties Short Course #2: Analytical and Bioanalytical Assay Development for Biological Therapeutics H H H H H H H H H H H H A Academic B Consultant C Corporate Management D Engineer E Marketing/Sales F Media G Production/Planning H Purchasing I QA/QC J R&D K Regulatory Sciences L Other H H H H H H H H H H H H G Foods H Government I Manufacturing J Materials Manufacturing K Medical Devices/Diagnostics L Publications M Other H H H H H H H H Purchasing Authority A Authorize B Purchase C Recommend D Specify E No Purchasing Authority I Packaging J Pumps K Raw Materials L Software M Spectroscopy N Tablet Presses O Test Equipment P Other Area of Interest (Check all that apply) Join AAPS Today and Save on Registration Fees! H Regular Member $145 (RM) H Full-Time Graduate Student/Undergraduate Student $30 (ST) Primary Business/Industry (Check one) H H H H H H A Academia B Analytical Testing Lab C Association D Biotechnology E Contract/Clinical Research F Cosmetics H H H H H H H H 31 A Analytical Services B Chemicals C Chromatography D Contract/Clinical Services E Dissolution Test Equipment F Drug Delivery Systems G Excipients H Ingredients H Postdoctoral Fellow $30 (PD) H Retired Member $50 (RT) 2009 AAPS NATIONAL BIOTECHNOLOGY CONFERENCE PRELIMINARY PROGRAM http://www.aapspharmaceutica.com/nationalbiotech
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