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Home
Events
Upcoming Conferences
Physician of the Year
Med Student Reception
Presentations Archive
Newsletter
About Us
About Us
Board of Directors
Get Involved
Physician of the Year
Governmental Affairs
Med Student Reception
Get Involved
AAFP Opportunity
Contact Us
Attendee Registration
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Register today and join us to earn up to 21.00 Prescribed credits!
Select Your Registration Type
*
AAFP Member Licensed Practicing Physician - $775.00
Non-member Licensed Practicing Physician - $950.00
PhD - $775.00
NP/PA/RN/PharmD - $600.00
Retired Physician - $575.00
Family Medicine Resident (Free) - $0.00
Medical Student (Free) - $0.00
Name
*
First
Last
Designation
*
MD
MD
DO
NP
PA
RN
PharmD
PhD
Resident Physician
Medical Student
AAFP ID Number
*
7 digit number
AAFP ID Number
7 digit number
Email
*
Email
Confirm Email
Phone
*
Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Would you like to sponsor a student?
*
Yes, I would love to! - $75.00
No, Thank you - $0.00
Your registration includes complimentary breakfast, lunch, and snacks all three days, plus one free adult dinner ticket for the special Thursday and Friday dinners. In an effort to reduce food waste, please select the appropriate responses below.
Your registration includes one free adult dinner ticket for Thursday and Friday. If you do not plan on attending the dinner(s), please choose the appropriate response below to help us reduce food waste.
Would you like to attend the all level Yoga class Saturday morning at 7am? *Space is limited to the first 32 participants.
*
Yes
No
Which meals will you be joining us for on Thursday?
*
Breakfast
Lunch
Snack
Dinner, please reserve me a free ticket.
I will eat on my own
Which meals will you be joining us for on Friday?
*
Breakfast
Lunch
Snack
Dinner, please reserve me a free ticket.
I will eat on my own
Which meals will you be joining us for on Saturday?
*
Breakfast
Lunch
I will eat on my own
Do you need to purchase additional dinner meal tickets for family members? Children 5 and under are free.
*
Yes
No
Thursday Welcome Dinner - Adult $50
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Thursday Welcome Dinner - Child (6-12) $25
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Friday Awards Dinner - Adult $55
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Friday Awards Dinner - Child (6-12) $30
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10
Total
$0.00
Your registration is finalized once you complete payment after submitting this form. Any unpaid balance will be due when you check in at registration.
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