AOCD 2014 Midyear Meeting Event Registration
Ritz Carlton-Dallas
2121 McKinney Avenue
Dallas, Texas 75201
February 20-23, ...
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2015 AOCD Midyear Meeting

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2015 AOCD Midyear Meeting

  1. 1. AOCD 2014 Midyear Meeting Event Registration Ritz Carlton-Dallas 2121 McKinney Avenue Dallas, Texas 75201 February 20-23, 2014 Name________________________________________________________________ (please print) Name of Guest (s) ______________________________________________________ Address ______________________________________________________________ City ____________________________________________State_____ Zip _________ Telephone ___________________________Email:_____________________________ Fax completed registration form with credit card information to (660)627-2623, or mail to: AOCD PO Box 7525 Kirksville, MO 63501 Regular Registration (Until –November 1, 2013) Late Registration (After November 1, 2013) ___AOCD Member ($500) ___AOCD Member ($600) ___Non-AOCD Member ($600) ___Non-AOCD Member ($700) ___AOCD Resident ($0) ___AOCD Resident ($0) ___AOCD Student ($25) ___AOCD Student ($50) ___Dermatology Physician Assistant ($300) ___Dermatology Physician Assistant ($400) ___Guests ($50) ___Guests ($50) This program anticipates being approved for 21 hours of AOA Category 1-A credit pending approval by the AOA CCME. Cancellation and Refund Policy Full refunds (less $100 processing fee) are available if requested in writing at least one month prior to the date of the Program The AOCD is not responsible for “acts of god” such as inclement weather, delays in airline travel, or governmental restrictions on travel due to national emergencies. Refunds will not be made if participants are delayed or unable to attend because of these issues. We reserve the right to withdraw the program or to make changes in the published itinerary whenever conditions warrant or if it is deemed necessary. Total Fee_____________ MC/Visa #_______________________________ Exp. Date________ CVV Code_____ Signature__________________________________ Hotel reservations are the responsibility of the attendee by calling 800-542-8680, or book online at www.ritzcarlton.com

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