REGISTRATION FORM

Administrators in Medicine (AIM)

National Organization for State Medical and Osteopathic Board Executives

AIM Institute: 2007 State Medical Board Investigator Certification Program

 

Investigator Training Dates: June 6-8, 2007 - Page Down for Further Information

Disney’s Coronado Springs Resort

Orlando, Florida

 

MEETING REGISTRATION FEE IS $750 PER PERSON

  •   Three-day training seminar - Limited to 50 attendees

·         Please make checks payable to: Administrators in Medicine

·         AIM Federal ID Number:  74-2329314                

·         Send Check to the AIM Treasurer at this address: Randal C. Manning, AIM Treasurer, c/o Maine Board of Licensure in Medicine, 137 State House Station, Augusta, ME 04333 

Meeting Registration Fee Refunds:  All cancellations must be in writing.  Individuals who cancel more than 15 business days prior to the meeting are entitled to a refund of their registration fee, less a $30 processing charge. Cancellations made within 15 business days of the meeting are non-refundable.

Meeting Registration Fee - $750

Note the names of registrants covered by these fees and the total dollar amount submitted below

 

Total dollar amount submitted:  $_________________

LIST OF REGISTRANTS:

The first three lines of this information will be used for your name badge:

 

Name:  _____________________________________________________________________________________________________ 

 

Title: _______________________________________________________________________________________________________

 

Board/Organization:  ___________________________________________________________________________________________

 

Address: ____________________________________________________________________________________________________

 

City, State, Zip Code: __________________________________________________________________________________________

 

e-mail address: _______________________________________________________________________________________________

 

Telephone:____________________________________________________________________________________________________

 

Name:  _____________________________________________________________________________________________________ 

 

Title: _______________________________________________________________________________________________________

 

Board/Organization:  ___________________________________________________________________________________________

 

Address: ____________________________________________________________________________________________________

 

City, State, Zip Code: __________________________________________________________________________________________

 

e-mail address: _______________________________________________________________________________________________

 

Telephone:____________________________________________________________________________________________________

 

Name:  _____________________________________________________________________________________________________ 

 

Title: _______________________________________________________________________________________________________

 

Board/Organization:  ___________________________________________________________________________________________

 

Address: ____________________________________________________________________________________________________

 

City, State, Zip Code: __________________________________________________________________________________________

 

e-mail address: _______________________________________________________________________________________________

 

Telephone:____________________________________________________________________________________________________

 

Name:  _____________________________________________________________________________________________________ 

 

Title: _______________________________________________________________________________________________________

 

Board/Organization:  ___________________________________________________________________________________________

 

Address: ____________________________________________________________________________________________________

 

City, State, Zip Code: __________________________________________________________________________________________

 

e-mail address: _______________________________________________________________________________________________

 

Telephone:____________________________________________________________________________________________________

 

Name:  _____________________________________________________________________________________________________ 

 

Title: _______________________________________________________________________________________________________

 

Board/Organization:  ___________________________________________________________________________________________

 

Address: ____________________________________________________________________________________________________

 

City, State, Zip Code: __________________________________________________________________________________________

 

e-mail address: _______________________________________________________________________________________________

 

Telephone:____________________________________________________________________________________________________

 End of Registration Form


Further Information About the Training Seminar

 

June 6-8, 2007 (Arrival June 5)

 

This program is scheduled to be a three-day training seminar. Registration is $750 per person - includes all three training days.

 

Hotel: Disney’s Coronado Springs Resort  

Hotel Room Rate: Government Rate $89 single/double occupancy (with 11.5 percent tax $99 per night).  

 

Online Brochure: http://www.aimmembers.org/07investcertbrochure/

 

HOTEL RESERVATION & AIRPORT TRANSPORTATION DETAILS

Disney’s Coronado Springs Resort


AIRPORT GROUND TRANSPORTATION: CONSIDER USING DISNEY'S MAGICAL EXPRESS SERVICE - Book at least 10 days in advance

 The Service is Complimentary

Web Link to Disney's Magical Express Service: http://disneyworld.disney.go.com/wdw/resorts/content?id=DMEBenefitsPage

Q. What is the best way to get to Walt Disney World® Resort from the Orlando International Airport?

A. Your best option is to use Disney's Magical Express Service* or an airport shuttle, limousine or car rental.

With Disney's Magical Express Service, your vacation starts the moment you land at Orlando International Airport:

IF DRIVING - EXIT NUMBER IS 65 FOR DISNEY'S CORONADO SPRINGS RESORT

FOR DRIVING INSTRUCTIONS WITHIN FLORIDA AND OUT OF STATE: Use this web link to Disney's Transportation page: http://disneyworld.disney.go.com/wdw/common/helpFAQ?id=HelpFAQTransportationPage

HOTEL EXIT - Exit 65:
Attractions: Disney's Animal Kingdom® Theme Park, Disney's Wide World of Sports® Complex, Disney's Blizzard Beach

Disney's Animal Kingdom Resort Area: Disney's All-Star Movies Resort, Disney's All-Star Music Resort, Disney's All-Star Sports Resort, Disney's Coronado Springs Resort, Disney's Animal Kingdom Lodge, Disney's Pop Century Resort, Disney's Winter Summerland Miniature Golf Course


END OF INFORMATION