Registration: 22nd Annual Aloha Medical Conference
22nd Annual Aloha Medical Conference Registration Form
October 4-8, 2010
Fees Early Registration LATE Registration
HAPA Members $375 $450
Non-HAPA PAs, MDs, NPs $450 $525






**There is a $75.00 Late Registration fee for applications submitted after September19, 2010.

Daily Registration fee if you will only be attending certain days:
Monday, Tuesday, Thursday - $175   Friday - $90
Registration fee includes breakfast daily, three lunches and the banquet.


Required Information
( * = required field )
First Name:  *    
Last Name:  *    
Organization:  
Address:   *    
City:   *    
State:   *    
Zip Code:   *    
Email:  *    
Confirm Email:  *    
Phone:    *    
Additional Information
Type of Registration:   *  
if Certain Days Only, which days will you be attending:   Monday  
  Tuesday  
  Thursday  
  Friday  
Additional Banquet Guests ($30 each additional):
Do You Prefer Vegan Meals:   Yes    No  
 
Link to your representatives: local state or federal
If you would like to contact any of your elected representatives use this link capitol.hawaii.gov

Contact Us

PO Box 30355
Honolulu, HI
96820-0355

Voicemail/FAX:
888-PAS-HI40
888-727-4440
Email: HAPA
Conference Info:
email: Bob Null
phone (808) 432-8334