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BOOTH/SOUVENIR REGISTRATION
HOTEL RESERVATION
SOUVENIR
ABSTRACT
SPONSORSHIP
AKMG Grand Rapids, Michigan - July 20-22, 2023
1
Program Champions: 5000 USD
"Refund of Payments made through PayPal will incur a 3% PayPal Charge" In addition, the following cancellation charges apply:
Full page ad in convention souvenir
90 Days before the Convention start: 20% of the amount paid
Stage recognition
60 Days before the Convention start: 30% of the amount paid
Superior Hotel room for 3 nights
30 Days before the Convention start: 40% of the amount paid
4 Convention registrations
Less than 30 days before Convention start: No refund
4 Pre-Convention Reception Tickets
2
Program Patrons
: 3000 USD
Half-page ad in convention souvenir
Name recognition
Hotel room for 3 nights
2 Convention registrations
4
Regular Registration rates, after May 15, 2023!
Convention Registration: $699.00
(Includes attendance at all events on July 21 and July 22; $150 per person for attendance at the Pre-convention Reception)
Medical Students/Trainee Registration - $299
(Includes attendance at all events on July 21 and July 22; $125 per person for attendance at the Pre-convention Reception)
Residents/Fellows Registration - $599
(Includes attendance at all events on July 21 and July 22; Extra $150 per person for attendance at the Pre-convention Reception)
Ages 5 and under - Free
6- 12 ages - $499
($100 per person for attendance at the Pre-convention Reception)
Ages 13-17 - $599
(
$100 per person for attendance at the Pre-convention Reception
)
Age 18 and above - $699
(
$150 per person for attendance at the Pre-convention Reception
)
CME - $150 - For non members (Free for AKMG Life members)
Registrant Details
Select Registrant Type
Select
Physician/Dentist
Medical Students/Trainees
Residents/Fellows
Select country
Australia
Canada
India
United Arab Emirates
United Kingdom
USA
Select State
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Participants Details
Number of Participants
1
2
3
4
5
6
(Including Registrant)
Registration category
Select
AKMG Champion
AKMG Patron
AKMG Regular
Select Relation
Self(Registrant)
Spouse
Children 0-5
Children 6-12
Children 13-17
Age 18 and above
Guest
Membership Type
AKMG Life Member
Non Member
Medical students/Trainee
Residents/Fellows
OPT for CME
Yes
No
Pre-convention Reception (Thursday Registration)
Select
Yes
No
Upgrade to Full Page Souvenir AD
Select
Yes $ 500
No
Souvenir AD
Select
Half Page $500
Full Page $1000
Total: USD
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Meal Choice & Number:
Non Vegetarian
Non Vegetarian
1
2
3
4
5
6
Vegetarian
Vegetarian
1
2
3
4
5
6
Allergies / Other comments
Comments on Hotel Room
(We will try our best to meet your request based on availability)
Medical or Dental School
Registrant Speciality
Select
Allergy and Immunology
Anesthesiology
Cardiology
Dermatology
Endocrinolgy
Emergency medicine
Family medicine
Gastroenterology
Heme Oncology
Infectious diseases
Internal medicine
Nephrology
Neurology
Ophthalmology
Obstetrics and gynaecology
Orthopaedics
Pain Medicine
Pediatrics
Psychiatry
Pulmonary Medicine
Rheumatology
Surgery
Other
Spouse Speciality
Select
Allergy and Immunology
Anesthesiology
Cardiology
Dermatology
Endocrinolgy
Emergency medicine
Family medicine
Gastroenterology
Heme Oncology
Infectious diseases
Internal medicine
Nephrology
Neurology
Ophthalmology
Obstetrics and gynaecology
Orthopaedics
Pain Medicine
Pediatrics
Psychiatry
Pulmonary Medicine
Rheumatology
Surgery
Other
Read, acknowledged and accepted
I acknowledge and agree to abide by and engage in appropriate health and safety conduct that are appropriate at the time of the Convention which MAY include NOT attending the Meeting if ill; OR have recently been exposed to COVID-19; and providing the required attestations regarding COVID-19 proof of vaccinations or testing. I will follow the public health guidelines and travel regulations that will be in effect related to the venue Michigan, USA at the time of the convention (July 20-22, 2023).
Total: USD
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