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Association of VA Hematology/Oncology September 24–26, 2009 Millennium Hotel Minneapolis, MN 5th Annual Meeting - REGISTRATION INFORMATION Last Name: First Name: Address: City: State: Zip: Tel: Fax: E-mail: Please choose one (if applicable): I am a MD PA NP RN PharmD CTR Other ________ HOTEL RESERVATION AVAHO will cover the first two (2) nights stay on Thursday, September 24 and Friday, September 25. PLEASE REGISTER EARLY. Millennium Hotel Minneapolis 1313 Nicollet Mall | Minneapolis, MN 55403-2697 Toll-free: 866-866-8086 | Tel: (612) 332 6000 | Fax: (612) 359 2160 Website: http://www.millenniumhotels.com/millenniumminneapolis/ Each individual guest must make their own reservations by calling 1-866-866-8086 and identifying themselves as members of AVAHO. All individual reservations must be guaranteed with a major credit card, first night’s room rate plus tax. All guaranteed reservations must be cancelled prior to 4:00PM CST 72 hours prior to arrival to be refundable. Failure to cancel the room as instructed above will be the responsibility of the guest. ROOM RATE & TAX WILL BE COVERED BY AVAHO AFTER ARRIVAL. *** HOTEL RESERVATION DEADLINE: AUGUST 25, 2009 *** MEETING REGISTRATION There is no registration fee to attend the meeting. Please let us know which events you will be attending: Friday Welcome Reception/Dinner Saturday Lunch Breakout Sessions: Physicians Nurses Pharmacists Psycho-Social I have already registered for the VHA Conference through the online link below: https://vaww.trace.lrn.va.gov/registration/Default.asp?CourseID=3176 I have special dietary restrictions: _ ___________________________ (Vegan, Vegetarian, etc.) TRAVEL FUNDING Travel expenses will be the responsibility of the individual facility. Airfare will be provided for accepted oral and poster presentations. For submission instructions, please visit our website at www.avaho.org and click on the 2009 Meeting link. Partial travel support for AVAHO members may be available. MAIL OR FAX THIS FORM TO: Association of VA Hematology/Oncology For questions or inquiries, please contact: P.O. Box 2459 Sue Lentz, Administrator at 425-953-4757 Lynnwood, WA 98036 E-mail: firstname.lastname@example.org TEL: 425-953-4757 | FAX: 206-319-4601 Check out our website at www.avaho.org. Check out our website at www.avaho.org.
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