Registration

Please enter information in the form below to process registration for event 70th Annual Assembly & Exhibition Registration.

PLEASE NOTE: The following is the individual registration for physicians, staff and their guests. To view opportunities and registration for exhibitors, sponsors and conference advertisers, please view 70th Annual Assembly Exhibitors & Sponsors Registration Form (http://lafp.org/component/eventbooking/general/1-70th-annual-assembly-exhibitors-sponsors).

Step One: Contact Information

Salutation
First Name *
Last Name *
Designation
Mailing Address *
Address 2
City *
State *
Zip *
Phone *
Fax
Email *

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Step Two: Membership Information

AAFP ID#
Member of LAFP? *

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Step Three: Event Attendance

Please select which functions below that you will be attending. If doubtful, please leave blank. This will aid LAFP in receiving an accurate count for meals and social events. These events are included in full registrations, however RSVP is required. Additional tickets may be purchased below.
Thursday, August 3, 2017
Friday, August 4, 2017
Sunday, August 6, 2017

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Step Four: Registration

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Step Five: Guest Registration

Guest registration at $75 for an adult or child. Includes admission into the Welcome Reception, Awards & Installation Luncheon and Foundation Auction/President's Party.
Number of Guest(s)

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Step Six: Additional Options and Social Tickets

Sponsorship of student's attendance at Assembly ($75 each)
Donation to LAFP Foundation (number only)
Donation attributed to
Foundation Golf Tournament (Thursday, Aug. 3)
Foundation Auction & President's Party (Friday, Aug. 4)
Awards and Installation Luncheon (Saturday, Aug. 5)

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How did you hear about this meeting?
Please list any special dietary restrictions.

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Cancellation Policy & Payment Info

CANCELLATION POLICY: A written notice of cancellation must be sent to the LAFP office at 919 Tara Blvd., Baton Rouge, LA 70806. Notices received on/before July 3, 2017 will be refunded less a $100 administrative fee. No refund or cancellation will be made after July 3, 2017.
If you have any questions or comments, please contact the LAFP office at (225) 923-3313 or e-mail info@lafp.org.

Payment Information

$
 

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