Convention Registration/ Convention Fee Schedule

Hotel Registration is mandatory for attending Convention.

Registration Type

ATMA Member + CME	$ 450.00		0
ATMA Member (Retired) + CME	$ 350.00		0
ATMA Member (Students/ Resident)	$ 200.00		0
Spouse/Guests	$ 300.00		0
Children (9 years and above)	$ 150.00		0

Hotel Registration

Hotel Registration is mandatory for attending Convention.

Thursday, August 8, 2019

Regular	$ 114.00		0
Suite (3 Rooms)	$ 500.00		0

Friday, August 9, 2019

Regular	$ 154.00		0
Suite (3 Rooms)	$ 500.00		0

Saturday, August 10, 2019

Regular	$ 210.00		0
Suite (3 Rooms)	$ 500.00		0

Sunday, August 11, 2019

Regular	$ 114.00		0
Suite (3 Rooms)	$ 500.00		0

First Name *

Last Name *

Address *

City *

State *

Zip *

Medical College/ University Attended *

Email *

Hospital Affiliation

Phone

Specialty/ Job Title

Spouse’s/Guests Name

Children / Guests Names & Age

How Many Veg

How Many Non-Veg

Any Food Allergies

ATMA Member *

Yes

No

Pending Membership

Yes

No