2OTH ANNIVERSARY INTERNATIONAL CLINICAL SYMPOSIUM ...

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AMERICAN ACADEMY OFCRANIOFACIAL PAIN1985–2005TAKE ADVANTAGE OF“EARLY BIRD” SAVINGS!20th AnniversaryInternational SymposiumAugust 5–6, 2005Oklahoma City, OklahomaIMPORTANT DATESFRIDAY, MAY 13, 2005Early Bird Registration Deadline!(Doctors, act now to save on your symposium registration!Enrollment in some programs is limited;don’t delay!)FRIDAY, JULY 1, 2005Table Clinic Registration Deadline(Participate in the Symposium! Call Dr. PatrickBarrett at (360) 779-7711 for details!)FRIDAY, JULY 8, 2005Fellowship Exam RegistrationDeadline(Did you remember to submit all paperwork,credentials and your exam fee?)TUESDAY, JULY 12, 2005“AACP” Rate of $119.00 at theRenaissance® Oklahoma CityConvention Center Hotel Expires!(For guest room reservations, call (800) 468-3571or (405) 228-8000, or fax (405) 228-8080).JOIN AACP AND SAVE!Submit your completedmembership application(with processing fee), andregister for this Symposiumat AACP member rates!AACP is pleased to celebrate our20th anniversary in Oklahoma City,site of our first symposium!SYMPOSIUM REGISTRATIONAct now! Space is limited for many programs! To register, simply complete andreturn registration form (at right) with payment in full to:AACP Central OfficeAttn: 2005 Symposium Registration516 West Pipeline RoadHurst, TX 76053GUEST ROOM RESERVATIONSAACP Rate: $119.00 (single or double occupancy plustax) available on a first-come, first-served basis throughTuesday, July 12th,2005, or until all ofthe rooms in ourblock are sold, whicheverhappens first.Renaissance® Oklahoma City Convention Center Hotel10 North BroadwayOklahoma City, OK 73102Call: (800) 468-3571 or (405) 228-8000Check in time is 3:00 P.M. CST; check outtime is 11:00 A.M. CST. Cancellations will be accepted without penalty upto 48 hours prior to your scheduled arrival date.TRANSPORTATION TO/FROM AIRPORTTaxis or the Airport Express Shuttle(877-688-3311) are readily available. The10-mile, one-way trip from the airport to thehotel costs approximately $16.00 per person.GETTING AROUNDAt 625 square miles, Oklahoma City isAmerica’s third largest city. The OklahomaSpirit, a fleet of vintage-style rubber wheeledtrolleys, is made with the visitor in mind. Justone or two quarters (passes are also available)will take you from the hotel to the Bricktownentertainment district and throughout theheart of Downtown Oklahoma City.Online: www.aacfp.orgE-mail: central@aacfp.orgFax: (817) 282-8012Call: (800) 322-8651 or (817) 282-1501SPECIAL EVENTSAT - A - GLANCETHURSDAY, AUGUST 4TH1:00 P.M.Fellowship ExamFRIDAY, AUGUST 5TH7:00 A.M. – 7:45 A.M.New Member Breakfast5:00 P.M. – 7:00 P.M.President’s ReceptionSATURDAY, AUGUST 6TH12:30 P.M. – 2:00 P.M.Membership Meeting (in conjunctionwith Membership Luncheon)
AMERICAN ACADEMY OFCRANIOFACIAL PAIN1985–200520th AnniversaryInternational SymposiumAugust 5–6, 2005Oklahoma City, OklahomaREGISTRATION FEESMain Scientific Session:20 YEARS OF TMD &CRANIOFACIAL PAINAACP Members (by May 13): $545.00AACP Members (after May 13): $595.00Non-Members (by May 13): $695.00Non-Members (after May 13): $745.00FUNDAMENTALS OF TMDDIAGNOSIS & TREATMENT:BACK TO BASICS (PART 1)Doctors Only, please:AACP Members (by May 13): $545.00AACP Members (after May 13): $595.00Non-Members (by May 13): $695.00Non-Members (after May 13): $745.00CERTIFIED TMJ ASSISTANTPROGRAM (PART 1)Assistants Only, please:Employed by AACP Member: $245.00Employed by Non-Member: $395.00ADVANCED ASSISTANTSPROGRAMAssistants Only, please:Employed by AACP Member: $245.00Employed by Non-Member: $395.00CANCELLATION POLICIES■ Registration refunds (less 10%) must bereceived at least 14 days prior to symposiumstart date.■ Renaissance® Oklahoma City ConventionCenter Hotel allows cancellation of guestroom reservations without penalty up to 48hours prior to scheduled arrival.& & &SAVE TIME! Register online at www.aacfp.org1. ONLINEwww.aacfp.orgDoctor’s NameOffice AddressQUESTIONS?PART 1: CONTACT INFORMATIONCity State ZipPhoneE-mailPART 3: REGISTRATION PAYMENT METHOD (check one)Call: AACP Central Office at (800) 322-8651 or (817) 282-1501E-mail: central@aacfp.orgWrite: AACP, 516 W. Pipeline Road, Hurst, TX 76053REGISTER TODAY • LIMITED ENROLLMENT IN SELECTED PROGRAMS • ACT NOWAACP 20TH ANNIVERSARY INTERNATIONAL CLINICAL SYMPOSIUMAugust 5–6, 2005—Renaissance ® Oklahoma City Convention Center Hotel—Oklahoma City, OKFaxEmergency Contact (name/phone)(To be used only in case of an emergency while you are on site during this meeting.)PROGRAM* REGISTRANT NAMES FEE(From Left Column) SUB-TOTALMain Scientific Session:$ $20 YEARS OF TMD & 1. _____________________________________________________________________________________________________CRANIOFACIAL PAIN$ $2.Fundamentals of TMD$ $Diagnosis & Treatment: 1. _____________________________________________________________________________________________________Back to Basics (Part 1)$ $2.Certified TMJ Assistant$ $Program (Part 1) 1. _____________________________________________________________________________________________________$ $2. _____________________________________________________________________________________________________$ $3.Advanced Assistant$ $Program1. _____________________________________________________________________________________________________$ $2. _____________________________________________________________________________________________________$ $3.TOTAL REGISTRATION FEES $*Sorry, crossing between programs is not allowed. To attend lectures in multiple programs, you must register for each program separately.Check payable to AACP is enclosed in the amount of $________________________________________________Charge $________________ to the following credit card: VISA MasterCardCard NumberPART 2: REGISTRATION DETAIL (attach additional sheets if necessary!)ID Number (Last 3 digits from the number on the back of credit card)Signature (We cannot process your credit card order without your signature.)FOUR EASY WAYS TO REGISTER2. FAX FORM TO:(817) 282-80123. MAIL FORM TO:AACP516 W. Pipeline Rd.Hurst, TX 760534. E-MAIL:central@aacfp.org(In U.S. fundsand drawn froma U.S. bank)._ /Expiration DateDON’T DELAY!Enrollment is limited for many programs!
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