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AAAF Leadership Training Conference 2010 June 13-18, 2010 Final Registration by June 1, 2010, VERY IMPORTANT: Only ONE Person Per Form. Please print out this form and enter information legibly or
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Occupation: Doctor Family Status: Single Age: 35 E-mail: e-mail: Home Phone: 1. Cell Phone: 2. E-mail: Phone: Name: Male Occupation: Doctor Family Status: Married/Children & Seniors Age: 40 E-mail: e-mail: Home Phone: 1. Cell Phone: 2. Home Phone: 3. E-mail: Phone: The application fee is 100.00 (non-refundable) and a non-refundable security deposit will be required. Applicants are responsible for transportation to the Conference. Please make sure you have plenty of money for parking and registration costs. After completing the registration and security deposit processing, the application will be considered for a one-night stay at the conference. The deadline for applications to be considered for the conference is 2:00 PM on May 15, 2010. The Conference is held at the Conference Center on the campus of the University of Colorado Denver. You will leave your car and get on the bus which will ride to the Conference Center at the University of Colorado Denver. There will be no late entry to the Conference Center and you must arrive at the scheduled time to be eligible to stay. Registration Fee — 100.00 Application Fee — 100.00 Registration Deposit — 100.00 One Night Stay Fees — 60.00/night + 50.00 tax (100.00 payment), plus 6.00 security deposit, per application. Please make sure you have plenty of money for parking and registration costs. All registrations are non-refundable and non-transferable.

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