Kentucky Osteopathic Medical Association 2015 Annual Convention Pre-Medical Conference Saturday, June 27, 2015 9:00 a.m. – 3:00 p.m. ● Hyatt Regency Hotel ● Lexington, KY Goals • To familiarize pre-medical students and pre-medical advisors with osteopathic medicine. • To acquaint pre-medical students and pre-medical advisors with the admissions requirements, program of study, and student life offered by University of Pikeville-Kentucky College of Osteopathic Medicine. • To provide pre-medical students and pre-medical advisors the opportunity to interact with osteopathic physicians and to hear presentations on topics related to the practice of osteopathic medicine. • To receive individual guidance on the application process. Registration In order to participate in this Pre-Medical Conference, participants must register. Early registration is encouraged to reserve a space in this daylong program as space is limited. The deadline for registration is June 2, 2015. • Pre-Medical Advisors, Parents and Students - $20 each • Students receive overnight accommodations at the Hyatt Regency Hotel for the evening before the event, provided by KOMA. Advisors and other guests will pay for their own lodging. • Breakfast and Lunch on the day of the conference is provided for all registered. • Professional attire is suggested. Shirt and tie for men and dress slacks/skirts/dresses for women. No jeans, please. Osteopathic Medicine A complete system of medical care with a philosophy that combines the needs of the patient with current practices of medicine, surgery and obstetrics, and emphasizes the inter-relationships between structure and function, and appreciation of the body’s ability to heal itself. Kentucky Osteopathic Medical Association 2015 Annual Convention Pre-Medical Conference Registration Saturday, June 27, 2015 9:00 am – 3:00 pm Hyatt Regency Hotel Lexington, KY Please Type or Print Clearly. (One registration form per person.) Name (as you would like it to appear on your badge): First: Nickname: Last: Address: City: State: Zip: Daytime Phone: Email Address: (required) ❏ Student ($20) at College/University No cost housing is provided to students courtesy of KOMA for Friday, June 26, 2015 ONLY (Shared Occupancy). Additional accommodations may be made by contacting the Hyatt Regency Hotel. Reserve Room: ❏ Yes ❏ No Roommate Preference (Same Sex): If no preference, we will be placing you with a same sex roommate for the evening. Your roommate pairing will be sent to you after June 9. ❏ Advisor ($20) at College/University ❏ Parent ($20) of Payment: ❏ Check or Money Order (Made payable to KOMA) ❏ Credit card (fill in below) Credit Card Number: Exp Print Name: Signature: Registrations must be received by June 2, 2015. Please mail registration with payment to: KOMA ● 2424 American Lane ● Madison, WI 53704 Telephone: 608-441-1060 ● Fax: 608-443-2474 Email: [email protected]
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