Veteran Affairs Physician Assistant Association, Inc.

Conference ONLINE Registration
PAYMENT Form

Please click on ONE registration type ONLY:

We MUST have your Name, Address, City, State & ZIP AND a phone number, so please enter them on the form or we cannot guarantee your registration!!! "If you are paying with someone else's credit card, please enter your own name under 'Customer ID'". Otherwise, we will NOT be able to know WHO is attending the conference and may think the same person is registering twice in error.

Move on to the next one to register! Sorry, you're too late for the Early Bird registration...Regular registration rates are now in effect.   VAPAA Member $375 After 7/28)   Active Military $375 (After 7/28)   PA Students $200 (After 7/28) Non-VA Employed PAs** $425 (After 7/28)   Membership through the WEB page - $75.00 per year taken from your credit card. (Annual remittance of payment is required. We do NOT automatically charge your account each year.)

. ** Must be a Fellow Member of any constituent chapter of AAPA

(ONLY credit card payments may be transacted through this page.)

CONFERENCE HOTLINE... 1-866-828-2722 (ONLY available up to one week prior to conference, NOT during the conference.)

Thank You for attending the Conference!

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