Annual Meeting – Registration 2021 Annual Meeting! Free registration for Ohio AAP members and staff! Please select the option that best describes you: Current Ohio AAP Member Staff of a current Ohio AAP member Physician, but not current Ohio AAP Member Other Ohio AAP Member Annual Meeting 2021 Packages and Sessions Please select the 2021 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 None of the above - $0 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 Ohio AAP Foundation Fundraiser on Friday, October 29 from 11:30 am - 1:00 pm. Yes, I would like to register for the Zoom live virtual event - $0 No, I would not like to register - $0 Ohio AAP Partner Annual Meeting 2021 Packages and Sessions Please select the 2021 Annual Meeting Package(s) for which you would like to register: * Champion for Children (two-day) Package - $75 Friday Only - $50 Saturday Only - $50 None of the above - $0 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 Ohio AAP Foundation Fundraiser on Friday, October 29 from 11:30 am - 1:00 pm. Yes, I would like to register for the Zoom live virtual event - $0 No, I would not like to register - $0 Ohio AAP New Member Annual Meeting 2021 Packages and Sessions Packages include one year Ohio AAP membership dues. Please select the 2021 Annual Meeting Package(s) for which you would like to register: * Champion for Children (two-day) Package - $190 Friday Education Sessions - $190 Saturday Education Sessions - $190 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 only the Ohio AAP Foundation Fundraiser on Friday, October 29 from 11:30 am - 1:00 pm. Yes, I would like to register for the in person event - $60 Yes, I would like to register for the Zoom live virtual event - $0 No, I would not like to register - $0 Membership dues are not included in Fundraiser costs. Please select your preferred track for Saturday from 10:15 am - 12:15 pm * Addressing Obesity, Healthy Eating and Physical Activity Post-COVID-19 Mental Health, Anxiety and Depression: Affirming Mental Health Practices & Creating Supportive and Inclusive Spaces for LGBTQ+ Teens Diagnosis & Management of Emergent GI Issues: Reflux, Constipation, Abdominal Pain and Cow's Milk Allergies Preserving the Medical Home During COVID 19 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. Prizes include gift cards to Home Depot, Door Dash, Amazon and various restaurants. 1 ticket - $10 3 tickets - $20 10 tickets - $50 20 tickets - $100 0 tickets - $0 (Optional raffle ticket purchase; raffle prizes will be announced in October 2021 and winners drawn during the Foundation Fundraiser on October 29. You do not need to be present to win.) How you would like your donation recognized in print (individual name, name with partner or family, organization, etc.). Subtotal: Attendee Information Name * First Last Name and Credentials * Last, Credentials Organization/Practice * Preferred Street Address to Receive Mailed Meeting Materials * Street Address 2 City * State * OhioAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington, D.C.West VirginiaWisconsinWyoming Zip * Phone Number * Email Address * Facebook Name/Handle Information will be only used to tag attendees in selected posts relating to Annual Meeting 2021 Twitter Handle Information will be only used to tag attendees in selected posts relating to Annual Meeting 2021 What made you register for the meeting? (Check all that apply) * Interesting Topics Need for MOC Part II Credit Networking with Colleagues I was referred by:I was referred by: OtherOther Total Due ($): Text If you are human, leave this field blank.
