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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?:    

AAMA Membership

New Member Introductory Offer: Attend the full conference at the non-member rate and enjoy complimentary 2011 AAMA membership. 
YES, Sign me up for a complimentary 2011 AAMA Membership


Members, conveniently renew your 2011 membership dues now  $215 
Renew Now    Yes     No thank you, not at this time
Conference package options:

Early bird rates listed are valid for registrations received with payment by 10/15/2010.
AAMA Conference only
Includes Wednesday reception, continental breakfast, Thursday lunch, and Thursday & Friday sessions.
$595 Member       $715 Non-member       Not attending conference only
AAMA Federal Day only 
Includes continental breakfast, breaks, lunch and Wednesday sessions.  Choice of PM sessions: Service Breakouts or AAMA Pre-Conference.
$225 Member       $250 Non-member       Not attending Federal Day Only
I plan to attend  or
AAMA One Day only  -  Thursday
Includes continental breakfast, breaks, lunch and Thursday sessions.
$400 Member       $480 Non-member       Not attending Thursday only
AAMA One Day only  -  Friday 
Includes continental breakfast, breaks, and Friday AM sessions.
$200 Member       $250 Non-member       Not attending Friday only
AAMA Conference + Federal Day
Includes AAMA Conference, 3 continental breakfast, 5 breaks, 2 lunches and Wednesday sessions.  Choice of PM sessions: Service Breakouts or AAMA Pre-Conference.
$790 Member       $965 Non-member       Not attending Conference + Federal Day
AAMA Conference + Half Day Pre Conference
Includes AAMA Pre-Conference, Wednesday reception, 2 continental breakfasts, Thursday lunch, and Thursday & Friday sessions.
 $745 Member       $865 Non-member       Not attending Conference + Half Day

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. 

Includes AAMA Conference sessions, Wednesday reception, Thursday lunch and continental breakfasts.
$100 Member       $125 Non-member       Not attending

Guest:  $95   Guest    Yes    No    
 Guest fee includes Wednesday reception, continental breakfasts  & Thursday 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: 

 


          Forms submitted without payment will not be processed.
          Please print a copy of this form to send 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 full payment 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 10/16/2009

Headquarters Hotel: 
 
Hilton Clearwater Beach Resort
Clearwater, FL

 

 
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