Pain CME Conference Registration Name(Required) First Last DesignationMDDOMD ResidentDO ResidentMedical StudentOtherOther designation (if applicable)Email(Required) Phone(Required)Will you be attending in person or virtually?(Required)In PersonVirtualAny dietary restrictions?Registration(Required)KSA only – TNAFP/AAFP member ($150)KSA only – nonmember ($200)KSA only – resident or student ($0)Prescribing course only – TNAFP/AAFP member ($75)Prescribing course only – nonmember ($125)Prescribing course only – resident or student ($0)KSA + prescribing course – TNAFP/AAFP member ($200)KSA + prescribing course – nonmember ($300)KSA + prescribing course – resident or student ($0)Total Cancellation policy: TNAFP will issue a full refund for cancellation requests made in writing until Friday, March 7, less a $25 administrative fee. No refunds after March 7.Credit CardCard Details Cardholder Name
