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Annual Meeting 2022 Attendee Registration
Please select the option that best describes you:
Current Ohio AAP Member, Staff or Resident
Non-Member Physician (Dues for 2022-2023)
Non-Member Non-Physician
RESIDENTS: This does not include luncheon admission. If there are available donated spots to the luncheon we will reach out to residents in the priority that they register to fill spots. Please note: there will be a $10 no-show fee assessed following the event; the cancellation fee reflects food charges incurred by the Chapter in anticipation of your participation.
Ohio AAP Member Annual Meeting 2022 Packages and Sessions
Please select the 2022 Annual Meeting Package(s) for which you would like to register:
*
Champion for Children (two-day) Package for Ohio AAP Members- $0
Friday Only for Ohio AAP Members- $0
Saturday Only for Ohio AAP Members- $0
None of the above - $0
Champion for Children Package – Friday MOC/CME Tracks, Saturday Sessions
Friday Only - MOC/CME Tracks
Saturday Only - Saturday Sessions
I would like to register for the Ohio AAP Foundation Fundraiser on Friday, October 28 from 11:30 am - 1:00 pm.
Yes, I would like to register - $40
No, I would not like to register - $0
I would like to purchase a table for 8- $750
Ohio AAP Partner Annual Meeting 2022 Packages and Sessions
Please select the 2022 Annual Meeting Package(s) for which you would like to register:
*
Champion for Children (two-day) Package - $290
Friday Only - $265
Saturday Only - $265
None of the above - $0
Champion for Children Package – Friday MOC/CME Tracks, Saturday Sessions
Friday Only - MOC/CME Tracks
Saturday Only - Saturday Sessions
I would like to register for the Ohio AAP Foundation Fundraiser on Friday, October 29 from 11:30 am - 1:00 pm.
Yes, I would like to register - $60
No, I would not like to register - $0
I would like to purchase a table for 8 - $750
Ohio AAP New Member Annual Meeting 2022 Packages and Sessions
Please select the 2022 Annual Meeting Package(s) for which you would like to register:
*
Champion for Children (two-day) Package - $100
Friday Education Sessions - $75
Saturday Education Sessions - $75
Champion for Children Package – Friday MOC/CME Tracks, Saturday Sessions
Friday Only - MOC/CME Tracks
Saturday Only - Saturday Sessions
I would like to register for only the Ohio AAP Foundation Fundraiser on Friday, October 28 from 11:30 am - 1:00 pm.
Yes, I would like to register - $60
No, I would not like to register - $0
I would like to purchase a table for 8 - $750
Please select your preferred track for Saturday from 10:15 am - 12:15 pm
*
Sports Medicine Update
Aggressive Child, Oppositional Defiant Disorder (ODD) and How Trauma Plays a Roll
Pediatric Acne and Dermatology
Infant Feeding World Café: Case-Based Education
N/A I will not be attending Saturday's Education Session
I would like to make an additional donation of ________ to support the vaccine advocacy coalition, OC4V, at the Ohio AAP Foundation Luncheon.
(Optional Donation)
I would like to purchase raffle tickets to support OC4V for the Ohio AAP Foundation. Prizes include gift cards to Home Depot, Door Dash, Amazon and various restaurants.
1 ticket - $10
3 tickets - $20
10 tickets - $50
20 tickets - $100
0 tickets - $0
(Optional raffle ticket purchase; raffle prizes will be announced in October 2022 and winners drawn during the Foundation Fundraiser on October 28. You do not need to be present to win.)
How you would like your donation recognized in print (individual name, name with partner or family, organization, etc.).
Attendee Information
Name
*
First
Last Name and Credentials
*
Last, Credentials
Organization/Practice
*
Mailing Address
*
City
*
State
*
Ohio
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, D.C.
West Virginia
Wisconsin
Wyoming
Zip
*
Phone Number
*
Email Address
*
Facebook Name/Handle
Information will be only used to tag attendees in selected posts relating to Annual Meeting 2022
Twitter Handle
Information will be only used to tag attendees in selected posts relating to Annual Meeting 2022
What made you register for the meeting? (Check all that apply)
*
Interesting Topics
Need for MOC Part II Credit
Networking with Colleagues
I was referred by:
I was referred by:
Other
Other
What are you most looking forward to about attending Annual Meeting in-person?
I give Ohio AAP permission to share my contact information with attendees and vendors to learn about new opportunities (check all that apply)
Email
Phone
Address
Total Due ($):
If you are human, leave this field blank.
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