The registration fee includes course materials, morning coffee breaks, and lunches. In addition, following the conference you will receive a CD-ROM with the meeting transcript, EMR, dictionary, abstracts, the latest federal government information on the EMR, and commercial information. Space is very limited, so please register early. Registrants will be sent a letter of confirmation and directions to the conference site. Written cancellation must be received by 31 August 2000 to obtain a partial refund (a $50.00 administration fee will be retained). No refunds will be granted after 31 August 2000. Registrant Information (please print) Name-Degree/Certification ____________________________________________________ Title_______________________________________________________________________ Affiliation __________________________________________________________________ Company __________________________________________________________________ Mailing Address _____________________________________________________________ City / State / Zip _____________________________________________________________ Phone/Fax _________________________________________________________________ Please check the appropriate boxes Registration/payment made by 11 August 2000 (conference fee = $395) Registration/payment made after 11 August 2000
but before 11 September 2000 Registration/payment made after 11 September 2000 (conference fee = $495) I intend to participate in the session discussions by sharing information on: Topic Session _____________________________________________________________
Topic Session _____________________________________________________________ Payment Method Name on card Acct.# Signature Exp. Date Please mail or FAX this form to OR Register on-line at www.clma.org
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