CONTACT INFORMATION
First Name
*
Last Name
*
Title
*
MD
DO
N/A
Practice Name
Cell Number
Email
*
Address
*
Street Address
City
Please Select
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State
Zip Code
Will you be bringing a spouse and/or guest(s)?
*
Yes
No
How many?
*
Please Select
0
1
2
3
4
5
Spouse/Guest Name
Guest Name 2
Guest Name 3
Guest Name 4
Guest Name 5
REGISTRATION & PAYMENT
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Annual Meeting
Members: $325; Non-Members: $375; Allied Professionals: $100; Residents: $0
$
Free
Membership Status
Select One
AOS Member
Non-Member
Allied Professional (NP/PA/RN/SA)
Resident
Foot Club Meeting
$
250.00
Hand Meeting
$
200.00
Shoulder Meeting
$
250.00
Fishing
$230/person; includes lunch and beverage
$
Free
Quantity
0
1
2
3
4
5
6
Golf
$255/person; includes lunch
$
Free
Quantity
0
1
2
3
4
Debit/Credit Card Details
SUBMIT
Should be Empty: