PSAA

General Information

Meeting Registration Fee

Your Name:

Registration Fees

Employer:

Enter the number of attendees
	Early Bird	September 1-29*	On Site
Member #100	$550	$575	$650

Non-Member #101	$650	$675	$750

Guest #102	$300/day with lunch- Saturday November 1 or Sunday November 2

* FOR REGISTRATIONS THROUGH 9/29/08 SEE BELOW *REGISTRATIONS BETWEEN 9/30/08 - 10/15/08 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 10/31: PSAA Welcome Reception #200/#201	No Charge	$30

Saturday 11/01: PSAA Luncheon #300/#301	No Charge	$50

ASPS Opening Ceremonies #705/#706 and Welcome Reception	No Charge	$150

Sunday 11/02: PSAA Luncheon #400/#401	No Charge	$50

PSAA Presidential Reception #500/#501 and Banquet	No Charge	$80

Monday 11/03: APSA/PSAA Luncheon #600/#601	No Charge	$50

Monday 11/03: Evening Social Event Spirit of Chicago Dinner Cruise #700/#701	$75	$75

Tuesday 11/04: ASPS Presidential Dinner Dance Fairmont Chicago Hotel #738	$150	$150