APMA News - April 2012 - (Page 55)

PODIATRIC MEDICAL ASSISTANTS’ 2012 APMA ANNUAL SCIENTIFIC MEETING REGISTRATION FORM n Your Information First Name for Badge First Name for Badge First Name for Badge APMA Member? q Yes q No ASPMA Member? q Yes q No ASPMA Member? q Yes q No ASPMA Member? q Yes q No PMAC? q Yes q No PMAC? q Yes q No PMAC? q Yes q No Name Name Name DPM Employer Address City/State/ZIP Code Office Phone n ssistants’ A Fax E-mail APMA Annual Scientific Meeting Fee (circle appropriate amount) Until April 27, 2012 Until July 29, 2012 After July 29, 2012 q One Assistant $95.00 $195.00 $195.00 Each additional assistant from the same APMA Member practice receives a 25 percent discount. q Additional assistants (25 percent off) $71.25 $146.25 $146.25 Number of assistants registered: ____ total: $_______ n APMA 100th Anniversary Gala featuring Frank Caliendo Saturday, August 18, 8:00–11:00 p.m. Number of tickets (10 maximum): ___ at $50.00 per person until July 29 NOTE: After July 29, tickets are only available on site at $75 per person. total: $_______ n Hall of Fame Luncheon Thursday, August 16, 12:30–1:30 p.m. Marriott Wardman Park Number of tickets: ___ at $60.00 per person or $600 for a table of 10 Podiatry Management’s Hall of Fame Luncheon Honoring Oliver S. Foster, DPM, and Michael Davis Benefiting the APMA Educational Foundation Scholarship Fund. q I wish to donate (number of tickets) ____ to APMSA n total: $_______ Assistants’ APMA Annual Scientific Meeting Registration Amount $_______________ Please Note: n Educational topics are subject to change as the program schedule develops. n All registration fees must be paid in advance. n Full payment must be received with your registration form, or the TOTAL must be recorded as part of the sponsoring DPM’s registration. Registrations without complete payment will not be processed. n Registration for the APMA Annual Scientific Meeting includes educational sessions (unless otherwise noted), exhibit hall entry, and refreshment breaks. NOTE: There is a separate fee for the examinations and review courses—they are NOT included in the fee schedule on this page. n A confirmation of registration will be sent to you by fax, mail, or e-mail within five to 10 business days after receipt. n Written requests for registration refunds must be postmarked on or before July 15, 2012. Registration fees are refunded less a $50 processing fee. All refunds will be issued after the meeting has occurred. n No refunds will be made after July 15, 2012. Refunds are not granted to no-shows. The registration on this page is for assistants attending the APMA Annual Scientific Meeting only. Please see the reverse side of this form for a separate registration, schedule, and fee for the certification examinations and review courses offered by the ASPMA in conjunction with the Annual Scientific Meeting. (Note: Assistants’ examination fees must be paid separately and may not be included in this total.) Payment type (check one). Registration will not be processed unless accompanied by full payment. q Check enclosed in US dollars (payable to APMA, Inc.) q Mastercard q Visa q American Express q Discover Credit Card Number (please print clearly) Name on Card (please print) Authorized Signature Day Phone of Cardholder Expiration Date Mail your completed registration form to: American Podiatric Medical Association Annual Meeting Office 9312 Old Georgetown Road, Bethesda, MD 20814-1621 Or Fax to: 301-530-2752 as of 2/23/2012 APMA News April 2012 Date 55

Table of Contents for the Digital Edition of APMA News - April 2012

APMA News - April 2012
In This Issue
Contents
Gen Z and myFEET
Dr. Caporusso’s Inaugural Speech to the House of Delegates
The Nuts and Bolts of Your House
Residency Genesis: A Priority for the Profession
Forum Builds Profession-wide Consensus on Student Recruitment
APMA By the Decade: 1942–1951
Profiles in Progress: Postgraduate Education
2011 Podiatric Practice Survey: Insurance Plan Participation
Infection Control Issues in the Podiatric Setting
Committee Member Acknowledgements
Federal Advocacy Forum
APMAPAC Chair Report
IT Consultant
Visit the Nation’s Capital for The National
Annual Scientific Meeting Preliminary Program
Annual Scientific Meeting Registration Form
Annual Scientific Meeting Sponsors
Website Wisdom
Technofile
Small Business 101
APMA All Stars
In Short
Worthy of Note
Affiliates Corner
List of Affiliated Organizations
Insurance Advisor
New Members
Death Notices
APMAPAC Update
Development Update
Awards Nominations
Classified Advertising
Dates to Remember
Advertising Index
10 Questions
Your APMA

APMA News - April 2012