The WSA :: Annual Meeting Registration

ABA Number

First Name *

Last Name *

Company/Institutional Affiliation *

Credential(s) *

Address *

City *

State *

Zip Code *

Cell Phone *

Email Address *

Special Needs (please specify)

Registration Fees (includes course materials, CME credits, breakfasts, lunch and breaks) *

WSA Member: $0

WSA AA Member: $0

WSA AA Student Member: $0

WSA Resident Member: $0

WSA Retired Member: $0

WSA Medical Student Member: $0

MSA Member: $0

Non-Member: $225

Saturday Attendee Meals (FREE but must RSVP) *

Yes, I will attend breakfast

Yes, I will attend lunch

No, I will NOT attend any meals

Saturday Workshops *

I will attend the Point-of-Care Ultrasound Workshop

I will attend the Regional Anesthesia Technique Workshop

Saturday PBLDs

I will be attend the Regional/Pain PBLD

I will attend the Embodiment and Nervous System Regulation Exercise Practice PBLD

I will attend the Obstetrics PBLD

Lambeau Field Tour and Dinner *

Yes, I will attend theLambeau Field Tour and Dinner ($125 per person)

No, I will NOT attend

Sunday Attendee Meals (FREE but must RSVP) *

Yes, I will attend breakfast

No, I will NOT attend

Dietary Restrictions (please specify)

Method of Payment *

Check

Credit Card

No Payment Needed

WSA Annual Meeting Registration