State Conference 2021 Registration Form
Registration required by April 24, 2021. Use this form to confirm your registration for the IdSMA 2021 Virtual State Conference. If you are an Idaho member of the AAMA, you can attend the conference for free. To become a member, go to to sign up before registration. You will need your Member ID number (not your certification number) and expiration date for this registration. If you are choosing to pay for conference, rather than becoming a member, please contact Cindy Baird at 28-604-2267.
Email address *
Email address for zoom meeting link *
We will send out meeting information before the conference to this email address. Please make sure it is correct before submitting this form.
Name (please include both first & last): *
Address: *
Street Address only here.
City *
State *
Zip code *
Preferred Phone Number (no dashes, spaces, or special characters, please): *
Registration Type: *
Member status will be verified 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)
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.**
Membership Expiration Date (from your annual membership card). *
When did you purchase your AAMA Membership? *
This will not be a year greater than 2021.
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, 2020. 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, 2020. Please read Article XVI – AAMA House of Delegates
What would help you attend every local chapter meeting? *
Do you have any questions or suggestions for the IdSMA leadership? (This step is NOT required)
Any additional information you wish to include with your registration? (This step is NOT required)
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy