ASIPP : : : American Society Of Interventional Pain Physicians

" The Voice Of Interventional Pain Management "

ONLINE REGISTRATION
BOARD REVIEW COURSE
YOU MUST REGISTER SEPARATELY FOR THE ABIPP EXAMINATION which will be held on August 14
August 9-13, 2010

Renaissance Chicago Hotel • 1 West Wacker Drive. • Chicago, IL 60601 • (312) 372-7200

Workshop Registration Information:
American Society of Interventional Pain Physicians:		Registration Dates
Registration Fee for Board Review Courses:		Payment on or before 07/19/10	Payment after 07/19/10
Board Review Course (ASIPP Member Pricing)		$1,250	$1,450
Board Review Course (ASIPP Non-Member Pricing)		$1,500	$1,700
Fellow Discount (Click here only if you are currently in a pain fellowship program to receive discount)		50% Discount	50% Discount
Method of Payment:
Mastercard \| Visa \| Discover \| American Express
Card Number:		Exp. Date:	Security Code:
Cardholder's Name:

	Cancellation Policy: ASIPP requires a 30-day notice for registrant’s cancellation. Cancellations must be submitted in writing and received by July 19, 2010. An administrative fee of $200.00 will be assessed. Cancellations after July 19, 2009, but prior to July 26, 2010, will forfeit 50% of their registration fee. No cancellations accepted after July 26, 2009. Refunds will be sent after the conclusion of the meeting.