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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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Legislative | News Continued2012Certified <strong>Medical</strong> OfficeManager Class (CMOM)Thursday, <strong>April</strong> 26 & Friday, <strong>April</strong> 27 and Thursday, May 3 & Friday, May 4, 2012Time: 9:00 a.m. to 4:00 p.m. | Place: St. Marys <strong>Medical</strong> Center, Huntington, WV (Participants must attend all 4 days.)Participant InformationRegistrant:________________________________________________________ E-mail:__________________________________Practice Name:______________________________________________________________________________________________Street Address:______________________________________________________________________________________________City:___________________________________________________________ <strong>State</strong>:________________ Zip:_____________________Phone:______________________________________________ Fax:____________________________________________________Program Fee/Discount Policies:Registration Fee: $999 WVSMA members & PMI Certified Professionals: $899 (Includes instructional materials and exam fee.)Payment Method:q American Express q MasterCard q Visa q Discover q Check EnclosedPayable to:<strong>West</strong> <strong>Virginia</strong> <strong>State</strong> <strong>Medical</strong> <strong>Association</strong>Card No:_ ____________________________________________ Expiration Date: ____________V Code:_______________________(Three digit number on the back of your credit card.)Name As It Appears On Card:_____________________________________ Email address:_________________________________Confirmation will be sent by email.Signature:__________________________________________________________________________________________________Registration Methods: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 25364Fax registration form to: Karie Sharp • (304) 925-0345 Charge by phone: Karie Sharp • (304) 925-0342, ext. 12E-mail: karie@wvsma.comPresented through an exclusive partnership between:<strong>March</strong>/<strong>April</strong> 2012 | Vol. 108 47

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