Association of Medical Diagnostic Manufacturers -- AMDM

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AMDM Meeting Registration Form

All fields with a * are required for registration.

Attendee Information

First Name*

Last Name*

Title

Email Address*

Daytime Phone Number*(ex. 5555555555)

Company Information

Name

Street Address

City

State

Zip Code

•The meeting rates displayed are per person
•If the checkbox for any meeting is greyed out, that means the meeting has filled up and registration is closed.

AMDM IVD Regulatory Focus

If you have checked the box for the Regulatory Focus Meeting, you MUST select one of the options below. If you try to submit the form without selecting a meeting rate, you will get an error message and your registration will NOT be submitted.
	Government Agency ($495)
	AMDM Corporate Member ($695)
	Non-Member ($995)
	Press ($35)

Payment Information

Please send an invoice to the address listed.

Pay by Visa or Mastercard

Card Type*

Card Number*

Name on Card*

Expiration Date* /

3-digit Security Code (found on back of card)*

Zip Code for Card's Billing Address*