State Conference 2020 Registration Form
Use this form to confirm your payment and registration for the IdSMA 2020 State Conference. You can not submit this form without paying through PayPal first. If you do not have your receipt & transaction ID numbers from PayPal, please return to the website, select your registration options, and pay. Once you have paid through PayPal, you will get a confirmation page including receipt & transaction ID numbers. These may be on an email as well.
Email address *
Name (please include both first & last): *
Your answer
Address: *
Street Address only here.
Your answer
City *
Your answer
State *
Zip code *
Your answer
Preferred Phone Number (no dashes, spaces, or special characters, please): *
Your answer
PayPal Receipt & Transaction Numbers *
You can not submit this form without paying through PayPal first. Please return to the website, select your registration option, and pay. Once you have paid through PayPal, you will get a confirmation page including receipt & transaction ID numbers. These may be on an email as well. Enter these numbers here please.
Your answer
Email Used for PayPal Transaction *
Sometimes the email you use for PayPal and the one you listed above are different. Please tell us the email that was used to pay for your registration.
Your answer
Registration Option: *
Member status will be verified at registration and before CEUs are reported to the AAMA.
Number of Years you have been a Medical Assistant (CMA, RMA, or MA). *
Students please write: Student at (insert school name)
Your answer
Local Chapter Affiliation: *
AAMA Membership Number (Card will be verified at Registration): *
**This is NOT your certification number, this is the number on your AAMA Membership card.** If non-member please enter "Non-Member".
Your answer
Membership Expiration Date (from your annual membership card). Non-members skip this step.
This will not be a year greater than 2020.
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Have you ever held a Chapter Officer position, been a State Officer, or a National Delegate? *
Are You Interested in Running for a State Officer Position? *
Article IX, of the IdSMA bylaws state: A candidate for office of IDSMA shall: A) Be an active member in good standing. B) Must be a CMA (AAMA). C) Submit qualifications for office and written consent to serve to the Chair of the Nominating Committee. Article XI, C) The candidate eligibility will be verified via AAMA member list or website of dues paid by the 31st of December. Please read Article X - Duties of Officers
Are You Interested in Running for a Delegate Position? *
Article VIII, SECTION 3. To serve as a delegate or an alternate to the House of Delegates of the AAMA, a member’s dues shall be postmarked to the Executive Office of AAMA by December 31. Please read Article XVI – AAMA House of Delegates
What would help you attend every local chapter meeting? *
Your answer
Do you have any questions or suggestions for the IdSMA leadership? (This step is NOT required)
Your answer
Any additional information you wish to include with your registration? (This step is NOT required)
Your answer
A copy of your responses will be emailed to the address you provided.
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