Michigan Association of Osteopathic Family Physicians

MAOFP Summer Family Medicine Update
July 30 - August 2, 2009
Hagerty Conference Center in Traverse City, Michigan
Conference pre-registration deadline is Mon., July 20, 2009.

Thank you for supporting the Michigan Association of Osteopathic Family Physicians. To register for our conference, please complete and submit the following secure online payment form. For questions, contact us at (800) 657-1556 or scarson@mi-osteopathic.org.

If you prefer to register by US mail, click here to download the printable PDF application and send us both the form and payment.

* Required Fields

AOA Number:

* Name:

* Address:

* City:

* State:

* Zip:

* Phone:

Fax:

* Email:

Registration Fee after July 20, 2009:

Membership Renewal Information:

Not sure if your dues are current? Call (800) 657-1556 to verify.

Please add me to your email distribution list to receive MAOFP information.

In honor of
Mary Goldman, D.O.
Saturday, August 1, 2009
Reception 6:00 p.m.
Dinner and Awards Ceremony 7:00 p.m.

Yes, I will be attending the Banquet # of Adults attending
No, I will not be attending the Banquet

You will receive two complimentary dinner tickets with your conference registration fee. However, additional tickets must be purchased.

Please indicate additional guests:

Adults $45.00/person:

Children $20.00/person:

Total:

Refund Policy: No Refunds after July 13, 2009.

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2445 Woodlake Circle, Okemos, MI 48864 \| Phone: 800-657-1556 \| Fax: 517-347-1566 \| Email: maofp@mi-osteopathic.org