AFMC ALUMNI MEDICAL CONVENTION JULY 30 – AUG 02, 2009 FORT LAUDERDALE, FLORIDA REGISTRATION FORM
NAME: _______________________________ ADDRESS: ______________________________________ _____________________________________ ______________________________________ _______________________ ADULTS:___ CHILDREN(UNDER 18)____ AFTER JUNE 01, 2009 US $ 649.00 US $ 549.00 US $ 449.00 US $ 50.00 US $ 100.00 BATCH:_________
E-MAIL:
NUMBER OF ATTENDEES:_______ FEES: UNTIL JUNE 01, 2009 FAMILY – US $ 599.00 COUPLE – US $ 499.00 SINGLE - US $ 399.00
LIFE MEMBERS DISCOUNT – GUESTS – PER DAY PER PERSON -
PLEASE MAKE CHECKS PAYABLE TO: AFMC ALUMNI MEDICAL CONVENTION MAIL TO: BALDEV SINGH, MD 2400 N UNIVERSITY DR SUITE 215 PEMBROKE PINES, FL 33024-3629 HOTEL RESORT RESERVATIONS: LAGO MAR RESORT AND CLUB GROUP RATES: US $ 135 + TAX PER NIGHT – REF AFMC ALUMNI RESORT E-MAIL: RESERVATIONS@LAGOMAR.COM 954-523-6511