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2010 AAMA Annual Conference Registration Form

To Register, you may either:

Call our offices directly at 847-759-8601
Mail in or Fax 847-759-8602 a Registration Form
Complete the online Registration Form below

Entry Instructions: Use tab key or point mouse to advance to next question.
DO NOT USE "ENTER" KEY UNTIL READY TO SUBMIT FORM.

If you would like to send us information regarding a previously submitted registration, please email our registration department. Do not complete another registration form.

Your conference badge will reflect the information filled in below.

Required fields are in red

Email:
Name:
If Federal Sector:     Rank        Branch
Designations/Credentials:
Badge Name:
Title:
Company:
Address:

City:        State:   Zip:
Country: Phone:
Fax:
New Address?: Yes    No

AAMA Membership

New Member Introductory Offer: Attend the full conference at the non-member rate and enjoy complimentary 2011 AAMA membership.

To qualify for a complimentary 2011 AAMA Membership, registrant must not have been an AAMA member since 2007

Members, conveniently renew your 2011 membership dues now $225
Renew Now Yes No thank you, not at this time

Conference package options:

Early bird rates listed are valid for registrations received by 10/15/2010.

AAMA Conference
Includes Wed-Fri sessions, all continental breakfasts, Wed-Thurs lunch, Wed reception, all breaks.
~~$850~~ $800 Member $1025 Non-member Not attending full conference

AAMA One Day only - Wednesday
Includes Wed sessions, Wed continental breakfast, Wed lunch, Wed reception and Wed breaks.
~~$460~~ $410 Member $490 Non-member Not attending Wednesday Only

AAMA One Day only - Thursday
Includes Thurs sessions, Thurs continental breakfast, Thurs lunch and Thurs breaks.
~~$460~~ $410 Member $490 Non-member Not attending Thursday only

AAMA One Day only - Friday
Includes Fri sessions, Fri continental breakfast and Fri break.
~~$260~~ $210 Member $290 Non-member Not attending Friday only

AAMA Conference Full-time Student (ID required)
Full-time student rate applies to individuals enrolled full time in a 4-year or graduate level health services program and not currently employed in a healthcare management position or holding a commission in military medical service for which full pay and allowances are received. Must submit proof of student status.

Includes Wed-Fri sessions, all continental breakfasts, Wed-Thurs lunch, Wed reception, all breaks.
$150 Member $200 Non-member Not attending as a Full-time student

Guest: $95 Guest Yes No
Guest fee includes Wed reception, all continental breakfasts & Thurs lunch.
Guest refers to a personal friend, not a business associate or staff member
Guest Name:

CAAMA EXAM Tuesday, November 16, 2010 1:00 - 5:00 pm or
Friday, November 19, 2010 12:00 - 4:00 pm
Registration Deadline is Friday, October 15, 2010

Exam Registration: $250 Yes No, I will not be taking the CAAMA Exam
Advance Registration and Payment Required

Special Needs (ex:Dietary)

Select Payment Type:

Pay Now with Credit Card
               Enter information below:
               Credit Card:
                       (Please enter numbers only. No separators.)
              Credit Card #:
            Expiration Date: mm/yy
              First Name:
              Last Name:
         Billing address of cardholder:
             Street:
               City:
               State: 2 letter code
               Zip:

Pay Later with Check or Credit Card
         Registrations received without payment information will be processed as a payment pending status.
         If not submitting payment online, please print a copy of this form to mail or fax with your payment.

If you are associated with the Department of Veterans Affairs/Uniformed Services and request payment on-site DO NOT give your credit card information. I understand that I do not qualify for the early-bird rate unless registration is received by Friday, October 15, 2010. NOTE: You still must complete the registration form, indicating your Conference Package selection, for us to process your registration.

You will receive a confirmation by mail within 2 weeks.

You can also mail your check or credit card information to the Academy office under separate cover. Be sure to include expiration date and signature for credit card payments. Checks should be made payable to "AAMA Foundation".

Please remit to:

AAMA Research & Educational Foundation
701 Lee St
Suite 600
Des Plaines, IL 60016

CANCELLATION POLICY
Cancellations must be received in writing by October 22, 2010, to qualify for a refund. A $50.00 processing fee will be deducted. Non-Members canceling before October 22, 2010, will be charged the $50.00 processing fee; the complimentary 2011 membership will be voided. After October 22, 2010, no refunds will be provided. No shows will be billed. Occasionally, changes in the conference may be made due to speaker availability, participant demand or unforeseen circumstances. While AAMA will do everything possible to ensure participant satisfaction, AAMA's liability is limited to the registration fee only.

EARLY REGISTRATION IS ENCOURAGED
Reservations at our hotel cannot be guaranteed after 10/15/2010

Note: By registering for this event, registrants agree that any conference photographs that include them as attendees may be used in future AAMA communications or promotional materials.

Headquarters Hotel:

Hilton Clearwater Beach Resort
Clearwater, FL

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