GAPA 2018 CME Conference
July 15 - 19
Sandestin • Florida
Sandestin Golf & Beach Resort


 

General Information


Registration includes breakfasts, lunches, refreshment breaks, commemorative attendee tote bag, and access to sessions and exhibits. Registration badges will be required for admission to all events. Payment is due with registration form and must be submitted by the below dates to qualify for corresponding rate. Materials can only be guaranteed to pre-registered attendees - be sure to register early.

GEORGIA PAs - If you wish to become a member of GAPA ($175), please check the checkbox on this form or complete our online form.

Please complete and submit the registration form below. One registration form per person. If you prefer, you may print this form with your browser and fax or mail to GAPA.


Date:
Note that items marked with an "*" are required fields.
PERSONAL INFORMATION
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*Please Select: PA-C    ARNP    PA Student    FNP
Other:
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*How did you learn about the conference:
(Check all that apply.)
AAPA CME Calendar
Conference Brochure
GAPA Website
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AdvancedPracticeJobs.com
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Other (please specify)    

REGISTRATION CATEGORY INFORMATION
SELECT CATEGORY ON/BEFORE
Jan 1
ON/BEFORE
March 1
ON/BEFORE
May 1
AFTER
May 1
GAPA PA Fellow Member

$675

$775 $825 $875
Retiree/Military
      (25% discount!)
$505 $580 $615 $655
GA PA Non-Members/ Other Professional $850 $950 $1,000 $1,050
Spouse/Guest**
-- no CME credits awarded
$200 $215 $230 $245
Spouse/Guest Name:
**Full guest registrations include the same items as a full conference registration except a CME certificate and select product theater luncheons. Product theater luncheons are healthcare provider attendance specific only.
One Day Registration:
Monday
Tuesday
Wednesday
Thursday
$270 $310 $330 $350
Student Track Only:
Monday
$50 $50 $50 $50
*If student, please list:
  o PA Program
  o Graduation Year: 4 digit year value only.  The entered year is less than the minimum allowed.  The entered year is greater than the maximum allowed.
Registration Fees Subtotal $
Discount for New PA Member $
Registration Fees Total $
MEMBERSHIP DUES

CURRENT GAPA MEMBERS:  Check this box to add additional $175 for your membership renewal dues

GA PA NON-MEMBERS:  Check this box to join GAPA. $175 will be deducted from your registration fee (giving you the GAPA Member rate) and $175 will be added for your Membership Dues. You will be granted fellow member status for the balance of the current membership period (January 1, 2018–December 31, 2018).

Membership Fees Subtotal $


WORKSHOPS (SUNDAY)

**Please see the event schedule before selecting your workshops. Some workshop times will overlap.


  Board Review (8AM - 5:30PM) $199
  MSK Ultrasound (8 -11 AM) $95
  Slit Lamp (8 - 10:30 AM) $90
  Crash Course in Clinical Skills (11:30 AM - 2:30 PM) $125
  ACLS (12 - 5 PM) $145
  Joint Injections (2 - 5 PM) $75
  Chest X-rays (2 - 5 PM) $90
  Suturing & Wound Techniques (3 - 6 PM) $125
  None  

GENERAL SESSIONS

Please select one track per day


MONDAY SESSIONS
 The Essence of Medicine: From Fast Track to Critical Care Thinking
  None
TUESDAY SESSIONS
  Orthopedics / Sports Medicine
  Managing Metabolic Mayhem
  None
WEDNESDAY SESSIONS

 50 Shades of Grey: The Grey Areas of Cardiology and How Not to Get "Tied Up"

in Them

 Derm 2018: Making Dermatology Great Again
  None
THURSDAY SESSIONS
 Knockin’ Your Noggin: What’s in Your Toolbox?
  None
 
Workshop Fees Total $

ADDITIONAL EVENTS
5K Fun Run Walk
$25 $
     5K T shirt size:  S:    M:    L:    XL:   
Golf Tournament
$100 $
Event Fees Subtotal $

PAC DONATIONS
A Chance To Protect And Promote Our Profession.
Your Generous Contribution Helps!

(Suggested minimum $25-$50)
Amount You Would Like To Donate: $

NURSE PRACTITIONER DISCOUNT – 15% off
To qualify for this discount, print this completed form and mail or fax to GAPA office.
Do NOT submit online.
  Nurse Practitioner Discount
        Name of colleague:
$

GRAND TOTAL $

PAYMENT INFORMATION
* Please complete all fields in this section.
Visa  MasterCard  Discover  American Express 

Please make a selection.

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REFUNDS: Written notice of cancellation must be received by June 5, 2018. A $75 administrative fee will be retained.

 

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MAIL OR FAX INSTRUCTIONS


Complete form and mail to: GAPA
1905 Woodstock Road, Suite 2150
Roswell, GA 30075
Complete form and fax to: 770-640-1095
Payment is due with registration form. If faxing, please include credit card number. To avoid duplicate charges, do not mail registration form if you have already faxed it or submitted it via this webform.
Make checks payable to GAPA (GAPA'S Tax ID#: 58-1296375)
In accordance with the Americans With Disabilities Act, please call the GAPA office if you have any special needs.


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