APMA Members

$300.00 - Registration on or BEFORE 10/15/2020
$350.00 - Registration AFTER 10/15/2020
$200.00 - NEOAPM Members ONLY BEFORE 10/15/2020
$250.00 - NEOAPM Members After 10/15/2020
$100.00 - APMA Life Members
$150.00 - APMA Life Members After 10/15/2020
$70.00 - Residents (with letter from residency director)
$130.00 - Residents After 10/15/2020
$70.00 - Students (with letter from Deanís office)
$130.00 - Students After 10/15/2020

NON - APMA Members

$400.00 - Registration Postmarked on or BEFORE 10/15/2020
$450.00 - Registration Postmarked AFTER 10/15/2020

Registrant Information

* = required field
Title
First Name *
Last Name *
Suffix
Email *
Email address must be a personal email NOT a business email
Address *
City *
State *
Zip *
Phone *
Fax
APMA #
State License #

Payment

Pay online now. This will show as a Stripe transaction on your credit card statement

  or print this page and return with check or money order to:
NEOAPM Fall Classic Seminar
32730 Walker Road, Suite I-3
Avon Lake, Ohio 44012