JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
AOASM 2020 Clinical Conference Refund Request
Please provide us with direction on how you would like to handle your registration for the recently cancelled 2020 AOASM Clinical Conference. Please email any questions to
info@aoasm.org
.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Last Name (as indicated when you registered)
*
Your answer
First Name
*
Your answer
Mailing Address
*
Your answer
City
*
Your answer
State
*
Your answer
Country
*
Your answer
Zip or Postal Code
*
Your answer
Did you sign up for additional events (workshop, Fellows Celebration, etc.)?
*
Yes
No
Other:
What should we do with your registration fee?
*
Process a refund
Transfer my registration fees to the AOASM Conference 2021, April 28-May 1, 2021
Donate my registration to the Rusty Wright Fund
What should we do with your pre-conference workshop fee?
*
Process a refund
Transfer my pre-conference workshop fee to the AOASM Conference 2021, April 26 and 27, 2021
Donate my pre-conference workshop fee to the Rusty Wright Fund
I did not register for a pre-conference workshop
What should we do with your event tickets?
*
Process a refund
Transfer my event tickets to the AOASM Conference 2021, April28-May 1, 2021
Donate the cost of my event tickets to the Rusty Wright Fund
I did not purchase any event tickets
Payee Name - If different than the information included with your registration - an institution and department, for example - please include the mailing information as well.
*
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
