April Member Event : Registration

April Member Event

Sponsored by Cox Healthcare
Thursday, April 10, 2025

Legacy Plaza

11:30am - 1:00pm
First Name*
Last Name*
Contact Information
Street Address
City
State
Zip Code
Email*

Confirmation EmailPlease confirm your email address. This will be how event information is communicated.
Cell Phone Number*
Please enter a valid phone number.
License Information
License Type*
Credentials
Billing
Are you a member of CMSA?*

YesNoNo, but I'm interested in finding out more information.No, but I'm attending as the guest of a sponsor.
CMSA Member Number
Sponsor Company
The cost for non-members to attend is $20. Would you rather pay ahead OR pay at the door?

Pay aheadPay at the door
Where should we send your receipt? (if different than the email listed above)
example@example.com
Should be Empty:

April Member Event