Association of VA Hematology/Oncology by 72z4fy

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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: sclentz@aol.com
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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