Spring Refresher 2012 Registration
(Residents & Medical Students Only)

Name

Mailing address

Phone

Email Address

PLEASE CHECK THE DAYS YOU PLAN TO ATTEND:
Thursday, April 26, 2012
Friday, April 27, 2012

PLEASE CHECK ONE:
Resident (MAFP Member) - Free
Resident (Non-Member) - $35/You will be invoiced.
Medical Student - Free

CONFERENCE HANDOUTS
All participants will receive CME handouts on a flashdrive with note-taking capability.  If you would like to purchase paper bound syllabus, you MUST preorder one below for a cost of $20.  (You will be invoiced.)

I would like a paper bound syllabus for a cost of $20.
Yes
No

NURSING MOTHER'S ROOM
Will you need to use the Nursing Mother's Room during the Spring Refresher?
Yes
No

RESIDENT/STUDENT LUNCH
Do you plan to attend the resident/student lunch at 12:00 P.M. on Thursday, April 26, 2012?
Yes
No

LUNCH  (One lunch ticket per day is included with registration)

Thursday
Regular
Vegetarian

List Any Guests for Thursday($20 each) and meal choice (reg/veg)(You will be invoiced.)

Friday
Regular
Vegetarian

List Any Guests for Friday ($20 each) and meal choice (reg/veg) (You will be invoiced.)

MAFP ALL-MEMBER CELEBRATION AND BUFFET-STYLE DINNER
Do you plan to attend the All-Member Celebration on Thursday, April 26, 2012, at 6:30 p.m.?
Yes
No

List Any Guests for All-Member Celebration ($10 each) (You will be invoiced.)

SPRING REFRESHER SESSIONS:  Please indicate the tracks you are likely to attend.  You responses will be used to determine room sizes, but are not binding and do not guarantee seating, which will be offered on a first-come, first-served basis.

Thursday, April 26, 2012

THURSDAY MORNING TRACKS (Choose One)

Pediatrics Track 10:30 a.m.
Rheumatology Track 10:30 a.m
Research Track 10:30 a.m
 

THURSDAY AFTERNOON TRACKS (Choose One)

Women's Health Track 3:30 p.m.
Oncology Track 3:30 p.m.
Neurology/Precepting Track 3:30 p.m.

 

Friday, April 27, 2012

FRIDAY MORNING TRACKS (Choose One)

Mental Health Track 10:30 a.m.
Pulmonary Track 10:30 a.m.
Practice Management Track 10:30 a.m.
   

FRIDAY AFTERNOON TRACKS (Choose One)

GI Track 1:15 p.m.
ENT Track 1:15 p.m.
Physician Resources Track 1:15 p.m.