2020 Annual Meeting Registration Master 2020 Annual Meeting Registration Are you currently a: Ohio AAP Member or Staff of Ohio AAP Member Medical Student or Resident Non-Ohio AAP Member Are you a physician? Yes No Annual Meeting 2020 Packages and Sessions Please select the 2020 Annual Meeting Package(s) for which you would like to register: * Champion for Children (two-day) Package for Ohio AAP Members- $0 Friday Only for Ohio AAP Members- $0 Saturday Only for Ohio AAP Members- $0 Individual Session(s) Only- $0 Champion for Children Package – Friday MOC/CME Tracks, Saturday Sessions Friday Only - MOC/CME Tracks Saturday Only - Saturday Sessions Please select the session(s) you would like to attend on Friday, November 20: Pre-Annual Meeting Workshop (Physical and Financial Fitness) Store It Safe Fundraiser Post-Election Federal Legislative Update State Advocacy Update Articles that Change the Way We Practice in Ohio COVID-19 in Pediatrics Panel Please select the session(s) you would like to attend on Saturday, November 21 (concurrent sessions noted - please select only one concurrent session): Ohio AAP Annual Breakfast Meeting Adolescent Vaping 101 (Concurrent Session) Preventing Infant Mortality Between Pregnancy: Interconception Care (Concurrent Session) Panel of Emerging Science in Play, Hunger Cues and Food Allergies (Concurrent Session) I would like to register for the Store It Safe Fundraiser on Friday, November 20 from 11:30 am - 1:00 pm. (Registration is free, but optional donations and/or raffle ticket purchases are encouraged.) Yes, I would like to register No, I would not like to register I would like to attend the Pre-Annual Meeting Workshop: Physical and Financial Fitness. November 20, 2020 9-11 am * Yes, I would like to attend No, I would not like to attend Please select your preferred track for Saturday from 10:30 am - 12:30 pm * Panel of Emerging Science in Play, Hunger Cues and Food Allergies Preventing Infant Mortality Between Pregnancy: Interconception Care Adolescent Vaping 101 I would like to make an additional donation of ________ to support the Store It Safe program of the Ohio AAP Foundation. (Optional Donation) I would like to purchase raffle tickets to support the Store It Safe program of the Ohio AAP Foundation. 1 ticket - $10 3 tickets - $20 10 tickets - $50 20 tickets - $100 0 tickets - $0 (Optional raffle ticket purchase. Raffle tickets will be provided the week of November 16 to those with advance purchases; additional raffle tickets will be sold during the Store It Safe Fundraiser November 20. Raffle prizes will be announced in November 2020.) How you would like your donation recognized in print (individual name, name with partner or family, organization, etc.). Subtotal: Attendee Information Name * First Last Name and Credentials * Last, Credentials Organization/Practice * Preferred Street Address to Receive Mailed Meeting Materials (if provided) * Street Address 2 City * State * OhioAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington, D.C.West VirginiaWisconsinWyoming Zip * Phone Number * Email Address * Facebook Name/Handle Information will be only used to tag attendees in selected posts relating to Annual Meeting 2020 Twitter Handle Information will be only used to tag attendees in selected posts relating to Annual Meeting 2020 What made you register for the meeting? (Check all that apply) * Interesting Topics Need for MOC Part II Credit Networking with Colleagues Virtual Format I was referred by:I was referred by: OtherOther Total Due ($): Text Annual Meeting 2020 Packages and Sessions Please select the 2020 Annual Meeting Package(s) for which you would like to register: * Champion for Children (two-day) Package for Non-Ohio AAP Members- $75 Friday Only for Non-Ohio AAP Members- $50 Saturday Only for Non-Ohio AAP Members- $50 Champion for Children Package – Friday MOC/CME Tracks, Saturday Sessions Friday Only - MOC/CME Tracks Saturday Only - Saturday Sessions I would like to register for the Store It Safe Fundraiser on Friday, November 20 from 11:30 am - 1:00 pm. (Registration is free, but optional donations and/or raffle ticket purchases are encouraged.) Yes, I would like to register No, I would not like to register I would like to attend the Pre-Annual Meeting Workshop: Physical and Financial Fitness. November 20, 2020 9-11 am * Yes, I would like to attend No, I would not like to attend Please select your preferred track for Saturday from 10:30 am - 12:30 pm * Panel of Emerging Science in Play, Hunger Cues and Food Allergies Preventing Infant Mortality Between Pregnancy: Interconception Care Adolescent Vaping 101 I would like to make an additional donation of ________ to support the Store It Safe program of the Ohio AAP Foundation. (Optional Donation) I would like to purchase raffle tickets to support the Store It Safe program of the Ohio AAP Foundation. 1 ticket - $10 3 tickets - $20 10 tickets - $50 20 tickets - $100 0 tickets - $0 (Optional raffle ticket purchase. Raffle tickets will be provided the week of November 16 to those with advance purchases; additional raffle tickets will be sold during the Store It Safe Fundraiser November 20. Raffle prizes will be announced in November 2020.) How you would like your donation recognized in print (individual name, name with partner or family, organization, etc.). Subtotal: Attendee Information Name * First Last Name and Credentials * Last, Credentials Organization/Practice * Preferred Street Address to Receive Mailed Meeting Materials (if provided) * Street Address 2 City * State * OhioAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington, D.C.West VirginiaWisconsinWyoming Zip * Phone Number * Email Address * Facebook Name/Handle Information will be only used to tag attendees in selected posts relating to Annual Meeting 2019 Twitter Handle Information will be only used to tag attendees in selected posts relating to Annual Meeting 2019 What made you register for the meeting? (Check all that apply) * Interesting Topics Need for MOC Part II Credit Networking with Colleagues Virtual Format I was referred by:I was referred by: OtherOther Total Due ($): Annual Meeting 2020 Packages and Sessions Please select the 2020 Annual Meeting Package(s) for which you would like to register: *Registration fee is your Ohio AAP membership dues. Your conference registration is free, you will receive a welcome packet in the coming weeks. * Champion for Children (two-day) Package for Non-Ohio AAP Members- $190 Friday Only for Non-Ohio AAP Members- $190 Saturday Only for Non-Ohio AAP Members- $190 Champion for Children Package – Ohio AAP Membership, Friday MOC/CME Tracks, Saturday Sessions Friday Only - Ohio AAP Membership, MOC/CME Tracks Saturday Only - Ohio AAP Membership, Saturday Sessions I would like to register for the Store It Safe Fundraiser on Friday, November 20 from 11:30 am - 1:00 pm. (Registration is free, but optional donations and/or raffle ticket purchases are encouraged.) Yes, I would like to register No, I would not like to register I would like to attend the Pre-Annual Meeting Workshop: Physical and Financial Fitness. November 20, 2020 9-11 am * Yes, I would like to attend No, I would not like to attend Please select your preferred track for Saturday from 10:30 am - 12:30 pm * Panel of Emerging Science in Play, Hunger Cues and Food Allergies Preventing Infant Mortality Between Pregnancy: Interconception Care Adolescent Vaping 101 I would like to make an additional donation of ________ to support the Store It Safe program of the Ohio AAP Foundation. (Optional Donation) I would like to purchase raffle tickets to support the Store It Safe program of the Ohio AAP Foundation. 1 ticket - $10 3 tickets - $20 10 tickets - $50 20 tickets - $100 0 tickets - $0 (Optional raffle ticket purchase. Raffle tickets will be provided the week of November 16 to those with advance purchases; additional raffle tickets will be sold during the Store It Safe Fundraiser November 20. Raffle prizes will be announced in November 2020.) How you would like your donation recognized in print (individual name, name with partner or family, organization, etc.). Subtotal: Attendee Information Name * First Last Name and Credentials * Last, Credentials Organization/Practice * Preferred Street Address to Receive Mailed Meeting Materials (if provided) * Street Address 2 City * State * OhioAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington, D.C.West VirginiaWisconsinWyoming Zip * Phone Number * Email Address * Facebook Name/Handle Information will be only used to tag attendees in selected posts relating to Annual Meeting 2019 Twitter Handle Information will be only used to tag attendees in selected posts relating to Annual Meeting 2019 What made you register for the meeting? (Check all that apply) * Interesting Topics Need for MOC Part II Credit Networking with Colleagues Virtual Format I was referred by:I was referred by: OtherOther Total Due ($): Total Due: If you are human, leave this field blank. Submit
