2018 IAFP Annual Conference
2018 IAFP Annual Conference Registration Form
No thank you
Specials Needs (Please list dietary allergies here) IAFP will make every effort to accommodate registrants with disabilities and special needs. Please notify IAFP if you require special accommodations or arrangements to fully participate.
A. Thursday, November 15 - Saturday, November 17 CME Registration Fees:
Early bird fees valid until 10/7/18
Select from below if you are an Active Member
New Physician Member (< 7 yrs in practice)
Select from below if you are a New Physician Member
Select from below if you are a Life/Inactive Member
Select from below if you are a Resident/Student Member
PA/NP who works in a FP Member office
Select from below if you are a PA/NP who works with a member
Non-Member (includes PA/NP)
Select from below if you are a Non-Member
To help with meal and material counts please select which sessions you will attending.
None of the options listed above
B. Optional Courses to be held on Saturday, November 17
Early bird fees available until 10/7/2018
Knowledge Self-Assessment - Health Behavior (4-6 hours)
Select below if you want to attend KSA Course
C. Installation/Awards Banquet:
Friday Evening, Installation/Awards Banquet:
Select Registered Attendee
Select Banquet Only
Select Guest Banquet Only
Enter the amount you would like to donate in the spaces provided below.
Rural Primary Care Loan Repayment Program
IAFP PrimCare PAC Donation
2 EASY WAYS TO Pay:
1. Once you hit submit your can pay with you PayPal account.
2. Mail payment to: IAFP, 100 East Grand Ave, Ste 240, Des Moines, IA 50309
Please hit the "Submit" button at the end of the on-line registration.
All attendees will receive a flash drive at the conference loaded with the syllabus free of charge. The syllabus will also be available online prior to the conference for you to download and print free of charge. NO PAPER COPIES WILL BE PROVIDED.
Do Not Fill This Out