; 2020 NYACP Scientific Meeting Registration Form - New York Chapter of the American College of Physicians

2020 NYACP Scientific Meeting Registration Form

NYACP's Annual Scientific Meeting-Virtual Meeting
Registration Form

Thursday, October 8, 2020
NYACP Virtual Business Meeting and Awards Reception

Friday, October 9, 2020
Virtual Annual Scientific Meeting


ACP Number
First Name *
Last Name *
Mailing Address *
City *
State *
Zip *
Phone *
Email *
NYACP Virtual Meeting (8:00 am to 1:00 pm)

Clear Selection
Member Reception 10/8 at 6 pm
Total Fees

Billing Information
You must list exactly the address your monthly cardholder statements are sent. 
Request for refunds must be made in writing before September 27, 2020 and are subject to a $20.00 administration fee.  No refunds will be given after September 28, 2020. If you are registering for a session with no fee, you need to include a credit card payment, however no amount will be processed.

If you have trouble processing your online registration, please contact Karen LaBello by email klabello@nyacp.org or contact the NYACP office at (518) 427-0366.   Contact Us      Privacy Policy     Site Map   

Name on Card *
Credit Card Billing Address (Street) *
Billing Address 2 (ie Apartment, Floor, Suite, etc)
City *
State *
Zip *

Payment Information

Amount to Charge :
Payment Method:

Fields marked with * are required.

Your form submission WILL be encrypted using SSL to ensure your privacy.

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