Topics in the Tropics 2017
Registration Form

Registration Fees

On or After Nov 1,2017
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Onsite
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Name (please print)(*)
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Home Address(*)
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City(*)
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State(*)
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Zipcode(*)
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Contact Phone(*)
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Contact Email(*)
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Profession(*)
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Payment(*)

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CC# (XXXX-XXXX-XXXX-XXXX)
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Exp. Date (mm/yy)
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CVS Number from back of credit card:
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This program has been reviewed and is approved for a maximum of 18.00 AAPA Category 1 CME credits by the AAPA Review Panel. PAs should claim only those credits actually spent participating in the CME activity.

This program was planned in accordance with AAPA CME Standards for Live Programs and for Commercial Support of Live Programs.AAPA Cat1 CMEJogo

Per Federal guidelines we can no longer accept credit card information via email. This form needs to be mailed or faxed as directed below. For questions email Fred Brace at fbrace@veteranscaucus.org.

Return to:
Veterans Caucus
PO BOX 362
Dover, DE 19903
Or fax to: 302-526-7154
For a hard copy to save, mail or fax: