PAP 2023 Annual Meeting Registration

Annual Meeting Registration
If you are having trouble completing the registration form, please contact PAP Meeting Manager, Jessica Winger at 717-909-2693 or jwinger@pamedsoc.org.
Name*

First NameLast Name
MD, DO, Other*
Email*
example@example.com
Institution/Organization*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Please list your dietary restrictions (allergy related):
Emergency Contact Name: *
Emergency Contact Phone*

Area CodePhone Number
Image, Video, and Audio Release
By registering and attending PAP Annual Scientific Meeting, I give consent for my image or voice to be used for marketing purposes including but not limited to digital and print materials. If you do not wish to have your photo taken, please contact PAP staff at info@papath.org.
Cancellation Policy
Cancellations received before April 3, 2023 will receive a refund less a $30 administrative fee. Any cancellations received after April 3, 2023 will not receive a refund. Refunds will not be issued for no-shows.
PAP will keep your address on file for CME purposes. We will also share a list of attendees with our exhibitors with your written permission. Please indicate below if you would like to opt in or out of the PAP Attendee list provided to our vendors.*

I would like to opt in to all options (share name, email and mailing address).Only share my name and mailing address (will not share email).Only share my name. (will not share mailing address or email).Opt Out (do not share any of my information with exhibitors).

Friday Reception & Dinner
Do you plan to attend the Friday Reception and Dinner?*

YesNo
Will you be bringing a guest?*

YesNo
Guest Name (for Badge)*
Guest Dietary Restrictions
Payment Information
You will need to add the following to your registration:

1. Registration Type

2. Friday Reception & Dinner (if attending)

3. Guest for Friday Reception & Dinner (if applicable)

My Products

Registration Type$155.00

Registration Type

Friday Jeopardy and Dinner (Physician)$50.00

# of Physicians Dinner

Friday Jeopardy and Dinner (Guest) $50.00

# of Guests Attending Dinner

Friday Jeopardy and Dinner (Resident)$40.00

# of Residents Attending Dinner

Total $0.00

Credit Card

Should be Empty:

Annual Meeting Registration

Friday Reception & Dinner

Payment Information

Credit Card