PSAA

General Information

Meeting Registration Fee

Your Name:

Registration Fees

Employer:

Enter the number of attendees
	Early Bird (before 8/1)	Advance (before 10/1)	On Site
Member #100	$550	$575	$650

Non-Member #101	$650	$675	$750

Guest #102	$300/day with lunch- Saturday October 24 or Sunday October 25

* FOR REGISTRATIONS THROUGH 9/30/09 SEE BELOW *REGISTRATIONS BETWEEN 10/1/09 - 10/14/09 should be faxed to Orla at 952-925-1579

Physician(s):

Address:

Suite:

City:

State:

Zip:

Phone:

Cell:

Fax:

Email:

Nickname for badge:

Spouse/guest name for badge:

Is this your first PSAA meeting?

Yes No

My hotel is:

Special Dietary or Other Considerations: (Please explain)

Dining and Social Events

Event	Members (enter#)	Guests (enter # )
Friday 10/23: PSAA Welcome Reception #200/#201	No Charge	$30

Friday 10/23: ASPS Welcome Reception #705/#706	No Charge	$150

Saturday 10/24: PSAA Luncheon #300/#301	No Charge	$50

Saturday 10/24: ASPS Opening Ceremonies #704	No Charge	No Charge

Sunday 10/25: PSAA Luncheon #400/#401	No Charge	$50

Sunday 10/25: PSAA Presidential Reception #500/#501 and Banquet	No Charge	$80

Monday 10/26: APSA/PSAA Luncheon #600/#601	No Charge	$50

Monday 10/26: PSAA Evening Social Event Purple Restaurant and Wine Bar #700/#701	$35	$35

Tuesday 10/27: ASPS Closing Session #735	No Charge	$50

Tuesday 10/27: ASPS Party with a Purpose #736/#737	$95	$95