FMM Residency Exhibit Application

2020 Residency Fair Exhibit Application

Each exhibit booth includes one free conference registration for a resident at your program, and we encourage all booth representatives to register for the conference and attend the online education sessions. Our residency fair format and exact schedule to be determined. Due to the virtual format - each program must purchase their own space - sharing will not be possible.

If you have any questions about registration, please call Ginnie Flynn at 630-427-8004 or email gflynn@iafp.com . Applications and payment are due September 27.
Residency Program Primary Contact
First Name *
Last Name *
Residency Program Name as it should be listed *
ACGME Number *
Location (City, State) *
Website *
Email Address *
Does your program offer J-1 Visas? *

Yes No Case by case basis
Does your program interview/consider international students? *

Yes No
Please upload your program logo here (PNG or JPG files only) *

Browse Files

Cancel of
Please provide 1-2 sentences summarizing the highlights of your program
Please click here if you had a booth at AAFP National Conference so we can bring your booth into FMM and you can just update it, rather than start from scratch

We had a booth at AAFP National Conference
Billing Address
Street Address
Address Line 2
City
State *
Postal Code / Zip Code
Phone Number *

About your participation
We will provide an invoice to your program by email or you can pay by credit card below *

Residency booth in the interactive residency fair at $400 Website advertising and listing only at $200 Please email me an invoice, I cannot use the CC processor below
Please list the names of the RESIDENT representative who will use the free registration, or TBD if you are not sure. You can submit names via email to gflynn@iafp.com by Oct. 1 *
Any additional information or other requests:

Credit Card Payment

USD Total payment