Home
Educational Talk: Diabetes 2017: An Update on Therapeutics
Start date : October 27, 2017
End date : October 27, 2017

First Name*:
Last Name*:
Email*:
Street Address:
City:
State:
Zip:
Phone (e.g. 5554441212):
Cell Phone (e.g. 5554441212):
Are you a current AAPIO member?*:
Will you be attending the dinner also?*:
 
 
 
  *EVENT REGISTRATION OPTION
 
SrNoOptionSelectCost
3113disabled3481AAPIO Member: FREE/person0.00
3113disabled3483AAPIO Member: onsite10.00

  ADDITIONAL OPTIONS

OptionHow manySelectCost
3113disabled3482Physician guest/person010.00
3113disabled3484Physician guest - AAPIO Member00.00
3113disabled3485Physician guest - AAPIO Member - onsite010.00
 
                                                                                              Total    
 
 
 
  *PAYMENT METHOD
 
Enter Name on Credit card* :
 
 
 PAYMENT TERMS
Educational talk and dinner is complimentary for AAPIO members who register online.  If your total is $0.00, then please click Check as payment method to complete your registration. For any other amount, please use either of the payment methods.
 
 CANCELLATION TERMS