ASIPP : : : American Society Of Interventional Pain Physicians

" The Voice Of Interventional Pain Management "

ONLINE REGISTRATION
ASIPP 11th ANNUAL MEETING
Evidence Based Medicine | Essentials of Practice Management
June 27-30, 2009

Crystal Gateway Marriott • 1700 Jefferson Davis Hwy • Arlington, VA 22202 • Phone: (703) 920-3230

Annual Meeting 2009 Registration Information American Society of Interventional Pain Physicians
Annual Meeting 2009 Registration Fees		Registration Dates
		Payment on or before 06/05/09	Payment after 06/05/09
ASIPP and/or SIPMS Member		$550 (Member)	$600 (Member)
Physician		$750 (Non-Member)	$800 (Non-Member)
Non-Physician		$600 (Non-Member)	$650 (Non-Member)
Associate Member		$350	$400
Fellow Resident		$200	$250
Medical Student		$25	$75
GALA CELEBRATION I wIll be Attending the 11th Anniversary Business Meeting & Dinner Party (There is no cost to attend for meeting registrants and one guest, but you must RSVP)		Name of Guest:
Method of Payment:
Mastercard \| Visa \| Discover \| American Express
Card Number:		Exp. Date:	Security Code:
Cardholder's Name:

	Cancellation Policy: The American Society of Interventional Pain Physicians requires a 30-day notice of cancellation. Cancellations must be submitted in writing and received by May 27, 2009; however, an administrative fee of $100 will be assessed. Cancellations after May 27, 2009, will forfeit 50% of their registration fee. No cancellations accepted after June 12, 2009. Refunds will be sent after the conclusion of the meeting. Organizers reserve the right to cancel this meeting and will assume no financial obligation to the registrants for cancellation. Although registration fees will be refunded, costs incurred by the registrant (i.e., airline fees, hotel fees, or penalties) are the responsibility of registrant.