Progress in Rehabilitation Research
ACRM 90 th Annual Conference ¨ Dr.
¨ Mr.
¨ Mrs. ¨ Ms.
2013 FORM
12 – 16 REGISTRation November
DISNEY’S CONTEMPORARY RESORT ORLANDO, FL, USA All pricing in USD
Online registration at www.ACRM.org
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First Name
Registration Date
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Community forums Nonmembers receive a complimentary 6-month ACRM membership with registration. Please select the ACRM groups below that are most relevant to You, so we may introduce you to opportunities and benefits available. ¨¨Brain Injury — Interdisciplinary Special Interest Group (BI-ISIG) ¨¨Spinal Cord Injury — Interdisciplinary Special Interest Group (SCI-ISIG) ¨¨Stroke — Interdisciplinary Special Interest Group (STROKE-ISIG) ¨¨Early Career — Networking Group ¨¨Health Policy — Networking Group ¨¨International — Networking Group ¨¨Outcomes Measurement — Networking Group ¨¨Military / Veterans Affairs — Group ¨¨Neurodegenerative Diseases — Group ¨¨Pediatric Rehabilitation — Group ¨¨Geriatric Rehabilitation — Group ¨¨Musculoskeletal/Pain — Group
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¨ First-time attendee Dietary / Special Needs
How did you hear about this event? What made you want to attend?
Attendee Type ¨¨Exhibitor ¨¨Rehabilitation Professional ¨¨Emeritus ¨¨Speaker ¨¨Consumer ¨¨Sponsor ¨¨Early Career (first 5 years following post-graduate studies) ¨¨Resident / Student / Fellow (Enrolled in an accredited school of medicine or approved graduate or under graduate program or fellowship in a medical rehabilitation discipline.)
Your registration includes access to ALL of the general sessions, plenary sessions and symposia Thursday, Friday and Saturday, 14 – 16 November.
Conference REGISTRATION
ADVANCE RATE 2012
EARLYEARLY BIRD
EARLY BIRD
REGULAR
ON-SITE
Please Check one
1 Feb – 3 Apr
4 Apr – 31 May
1 Jun – 30 Aug
31 Aug – 8 Nov
9 – 16 Nov
ACRM Member
¨¨ $595
¨¨ $695
¨¨ $795
¨¨ $895
¨¨ $1,095
Non-Member
¨¨ $795
¨¨ $895
¨¨ $995
¨¨ $1,095
¨¨ $1,295
¨¨ $150
¨¨ $295
¨¨ $295
¨¨ $395
¨¨ $495
Student / Resident / Fellow
Early Career
¨¨ $150
¨¨ $295
¨¨ $295
¨¨ $395
¨¨ $495
Day Registration (Member)
¨¨ $295
¨¨ $395
¨¨ $495
¨¨ $595
¨¨ $695
Day Registration (Non-Member)
¨¨ $295
¨¨ $495
¨¨ $595
¨¨ $695
¨¨ $795
Non-refundable Government Deposit
¨¨ $50
¨¨ $195
¨¨ $295
¨¨ $395
¨¨ N/A
non-member purchase includes a complimentary 6-month ACRM membership with a subscription to Archives of Physical Medicine and Rehabilitation.
Student / Resident / Fellow: Up to two years after post graduate studies / include graduation date. Early Career: Up to five years after post graduate studies / include graduation date.
Non-refundable Government Employee Deposit: U.S. government employees may pay a non-refundable
deposit to freeze their registration cost at the current rate to defer payment. Deposit will be applied to registration. Attendee will be invoiced and final payment will be due after 1 July 2013. www.ACRM.org
T: +1.703.435.5335