March/April - West Virginia State Medical Association
March/April - West Virginia State Medical Association
March/April - West Virginia State Medical Association
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Thursday, <strong>March</strong> 14 & Friday, <strong>March</strong> 15 and Thursday, <strong>March</strong> 21 & Friday, <strong>March</strong> 22, 2013<br />
Time: 9:00 a.m. to 4:00 p.m.<br />
2013<br />
Certified <strong>Medical</strong> Office<br />
Manager Class<br />
Place: <strong>West</strong> <strong>Virginia</strong> <strong>State</strong> <strong>Medical</strong> <strong>Association</strong><br />
(Participants must attend all 4 days.)<br />
4307 MacCorkle Ave., SE, Charleston, WV 25304<br />
Participant Information<br />
Registrant:________________________________________________________ E-mail:__________________________________<br />
Practice Name:______________________________________________________________________________________________<br />
Street Address:______________________________________________________________________________________________<br />
City:___________________________________________________________ <strong>State</strong>:________________ Zip:_____________________<br />
Phone:______________________________________ Fax:___________________________________________________________<br />
Program Fee/Discount Policies:<br />
Registration Fee: $999 WVSMA members & PMI Certified Professionals: $899 (Includes instructional materials and exam fee.)<br />
Payment Method:<br />
q American Express q MasterCard q Visa q Discover q Check Enclosed<br />
Payable to:<br />
<strong>West</strong> <strong>Virginia</strong> <strong>State</strong> <strong>Medical</strong> <strong>Association</strong><br />
AMOUNT PAID $___________________________________<br />
Card No:_ ____________________________________________ Expiration Date: __________________V Code:_ ________________<br />
(Three digit number on the back of your credit card.)<br />
Name As It Appears On Card:_________________________________________Email address:_____________________________<br />
Signature:__________________________________________________________________________________________________<br />
Registration Methods:<br />
Mail registration form to: Karie Sharp • <strong>West</strong> <strong>Virginia</strong> <strong>State</strong> <strong>Medical</strong> <strong>Association</strong> • PO Box 4106, Charleston, WV 25364<br />
Fax registration form to: Karie Sharp • (304) 925-0345 Charge by phone: Karie Sharp • (304) 925-0342, ext. 12<br />
E-mail: karie@wvsma.org<br />
Presented through an exclusive partnership between:
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