AAPIO                                                              
Arizona Association of Pharmacists of Indian Origin
Arizona Association of Pharmacists of Indian Origin
Event Pre-Registration

Pre-Register/Commnets  on Upcoming 'Pharmacy Law CE Event'
 (Registration Deadline is September 20, 2010)
(Registration processed after September 20, 2010 will be subject to a $5 late fee) 

(Program Fee is Due On or Before the Event Day either by Check or Cash)
Title*:
First Name*:
Last Name*:
Address Street 1*:
Address Street 2:
City*:
Zip Code*: (5 digits)
State*:
Email*:
Home Phone*:
Cell Phone*:
Total Guests*: (incl. you)
Comments*:
Will you be mailing the Check along with the completed form* ?






   

  If No -   1. Simply Submit the form ONLINE and
               2. You pay dues at the time of registration (on event day)

 If YES - 1. Print and mail the completed form along with the check & 
               2. Submit the Form ONLINE

                                                      (***PLEASE DO NOT MAIL CASH***)



Please make check payable to Arizona Association of Pharmcists of Indian Origin and Mail to:
AAPIO Event Registration
16211 N 99th Way
Scottsdale, Arizona 85260
JOIN US !  DOWNLOAD this Membership Form, fill it out and mail it to: 16211 N 99th Way, Scottsdale, AZ 85260