The 26th Annual Convention

North American Taiwanese Medical Association

 

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     2010年北美灣人醫師協會年會報名單

      North American Taiwanese Medical Association

                         26th Annual Convention

      (For updated info: http://natma.org/conventionstl.html)

 

Name of Member

Dr. Mr. Mrs. Ms. (English) ___________________ (Chinese) _______________________

Specialty: ______________ School/Year of Graduation: ______________________Class Reunion

Address:  _____________________________________ Email: _____________________________

Phone: ___________________  Cell Phone:___________________  (required  for airport shuttle service)

Flight info: ____________________________________________(Arrival Airline/Flight #/Date/Time)

                   ____________________________________________(Departure Airline/Flight #/Date/Time)

Accompanying Spouse (Non-member) or Guest(s). For member-spouse, use top for full info.

Dr. Mr. Mrs. Ms. (English) ___________________ (Chinese) ______________________

Dr. Mr. Mrs. Ms. (English) ___________________ (Chinese) ______________________

Registration Fees  ( Member in training or graduate student, resident, fellow, discount 50%)

Registration time schedule

Unit Charge

# of Persons

Subtotal

Early Bird (Registration Fee)

$50

X

$

After Aug 25, 2010 by Postmark

$70

X

$

Dining Options (Member/Guests)   Vegetarian X ______ (Meal plan detailed on Info. page )

Meal Plan A

$200

X

$

Meal Plan B

$170

X

$

Meal Plan C

$120

X

$

Tours and Activities

Golf  Outing  9/17 

$80 -100  ***

X

Pay at G C

St Louis City Half-Day Tour 9/19  (noon-5pm)

$45 (with Arch Tram)

$35 ( No Arch Tram)

X

X

$

Bento Lunch Box 9/19

(Required if attend city tour)

$10 

X

$

Subtotal 

$

Donation (A letter to acknowledge your contribution will be sent to you.)

$

Total (Payable to NATMA, mail to ShuIe Chang, 311 Sunway Lane, St Louis, MO 63141)

$

 

2010 NATMA 26th Annual Convention Registration Information:

Date: 09/17/2010 – 09/19/2010

Convention Site and Hotel:      Please make your reservation before Aug 16, 2010.

And mention NATMA for the special rate.  

St. Louis Marriott West Hotel (Group rate $72 plus tax per night)                                                     660 Maryville Centre Drive, St. Louis, Missouri 63141 USA                                                                 Phone:  1-314-878-2747  Toll-Free:  1-800-352-1175

Self- Parking is Complimentary.                                                                                                     

Airport Shuttle Service:

Complimentary PICKUP BY SHUTTLE BUS from and to the AIRPORT is provided.

Please make sure to provide your ARRIVAL/DEPARTURE FLIGHT INFORMATION and CELL PHONE NUMBER on the registration form for the pickup.

(Registration group contact: Kai-Chien Yang 314-766-6657)

Meal Plan: ( A, B, C )

                       Meal Plan

A

B

C

Lunch  9/17

$30

 

 

 Reception Dinner  9/17

$50

$50

 

 Working Lunch Buffet  9/18

$40

$40

$40

 Dinner Banquet  9/18

$80

$80

$80

 

Mail in Registration: Mail in your check (payable to NATMA) and registration form to:

       ShuIe Chang, 311 Sunway Lane, St Louis, MO 63141       (Registration Deadline Sep 2, 2010)

Refund/Cancellation Policy:

        Cancellation request should be in writing and postmarked by Sep 9, 2010 to avoid a 10% charge.

St Louis City Half-Day Tour: will cancel if fewer than 30 people attend

*** Golf Outing: Please contact  Dr. T.Z. Chen    314-878-6188 for reservation  and transportation