GAPA

GAPA 2019 CME Conference
July 15 - 19
Hilton Head Island • South Carolina
Hilton Head Marriott Resort & Spa


GAPA is going GREEN!

General Information


Registration includes breakfasts & refreshments, 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:
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AAPA CME Calendar
Conference Brochure
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AdvancedPracticeJobs.com
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REGISTRATION CATEGORY INFORMATION
SELECT CATEGORY ON/BEFORE
Jan 1
ON/BEFORE
March 1
ON/BEFORE
May 1
AFTER
May 1
GAPA PA Fellow Member $695 $795 $845 $895
Retiree/Military
      (10% discount!)
$625.50 $715.50 $760.50 $805.50
GA PA Non-Members/ Other Professional $870 $970 $1,020 $1,070
Spouse/Guest**
-- no CME credits awarded
$220 $235 $250 $265
Spouse/Guest Name:
**Full guest registrations include the same items as a full conference registration except a CME certificate and select product theater meals. Product theater meals are healthcare provider attendance specific only.
One Day Registration:
Tuesday
Wednesday
Thursday
Friday
$290 $330 $350 $370
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, 2019–December 31, 2019).
Membership Fees Subtotal $


WORKSHOPS

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


MONDAY
  Board Review (Sharma) (8:00 AM - 12:00 PM, 1:30 PM - 5:30 PM)
       (only available for Full Conference registrants)
FREE
  Basic Suturing (Gordon) (7:00 AM - 9:00 AM) $95
  Ignite Optimal Medicine CME Workshop (Bielinski) (8:00 AM - 12:00 PM, 1:30 PM - 5:30 PM) $149
  Advanced Suturing (Gordon) (9:30 AM - 11:30 AM) $95
  ACLS/BLS (Fullard) (12:00 PM 5:00 PM) $175
  Clinical Skills In the Acute Care Setting (Gordon) (12:30 PM 3:00 PM) $95
  Ortho Exams: Knee, Ankle & Upper Extremities (Vacala) (3:15 PM 5:45 PM) $95
TUESDAY
  EKG Bootcamp (Carlquist) (2:15 PM - 5:15 PM) $95
  Joint Injections (Vacala) (2:15 PM - 5:15 PM) $95
WEDNESDAY
  IUD Insertion (Watkins) (2:00 PM - 4:00 PM) $75
  Basic Fractures & Splinting in the Acute Care Setting (Vacala) (2:00 PM - 4:00 PM) $95
THURSDAY
  Basic Dermatology Procedures (Braselton) (2:00 PM - 5:00 PM) $125
  PALS/BCLS (Fullard) (2:00 PM - 5:00 PM) $175
  Night Shift In The ED: Case Based Radiology (Gordon) (2:00 PM - 5:00 PM) $95

GENERAL SESSIONS

Please select one track per day


TUESDAY SESSION
 Cardiology
  None
WEDNESDAY SESSIONS
  Orthopedic
  Women's Health
  None
THURSDAY SESSIONS
 Dermatology
 Pediatrics
  None
FRIDAY SESSIONS
 Emergency Medicine
  None
 
Workshop Fees Total $

ADDITIONAL EVENTS
5K Fun Run Walk
$25 $
  5K T shirt size:  S:    M:    L:    XL:   
Golf Tournament
$100 $
Family Beach Party
(One complimentary beach party ticket for every full conference registered attendees.)
Ages 0-3 (complimentary)
$0 $
Ages 4-12
$11.50 $
Ages 13 and up
$25 $
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: $

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 15, 2019. 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.


Stay Connected to GAPA! GAPA Goes Green

GAPA GREENIn an effort to lower our environmental impact and preserve our natural resources, GAPA has elected to Go Green! Please look for our Green logo to learn more about GAPA's Green Initiatives.