AAPICU Conference Registration Information
First Name *
Your answer
Last Name *
Your answer
Institution *
Your answer
Email *
Your answer
Will your spouse be attending the conference?
If so, what is your spouse's name?
Your answer
Will you attend the Thursday Dinner?
Will your spouse attend the Thursday Dinner?
Will you attend the Friday Luncheon?
Will your spouse attend the Friday Luncheon?
Dietary Restrictions (President)
Your answer
Dietary Restrictions (Spouse)
Your answer
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