SPRING CLINICAL LIPID UPDATE 2015 2015 Clinical Lipid Update Jointly hosted by the Southwest and Pacific regional chapters February 27–March1, 2015 Grand Hyatt Hotel • Denver, CO FEBRUARY 27–MARCH 1, 2015 DENVER, CO NATIONAL LIPID ASSOCIATION Guest name(s), if attending meeting: 1 First NameMiddle InitialLast Name Mailing Address Membership status: I am currently a member. My application for membership has been submitted and confirmed. I will apply at www.lipid.org. Please send me membership information. CityState or ProvinceZip Country Phone Email Check all that apply: 2 Emergency Contact/Phone MD/DO/PhD Circle fee based on attendee type RN Cell Phone NP PA RPH NLA Member NLA Member Non-member Early Bird Rate Discounted Rate Rate Before 1/27/15 After1/27/15 PharmD Trainee Rate† Clinical Lipid Update 3 4 $495 $545 $895$75 February 27–March 1, 2015 Enter Discou Includes one admission badge nt Code for to Exhibit Hall for all food $50 Off functions. Professional Development Masters in Lipidology Course$750 February 26–27, 2015 $1250$395* NLA Lipid Academy$550 $550 $950$0 February 26–27, 2015 Registration Fee Total $_______ $_______ $_______ $_______ Guest Fees and Special Events Exhibit Hall Pass-Guest(s)$150 Guest and Special Event Totals $150 Combined Total Fees –$ 50 $_____________ Payment Method VISA MC AMEX Credit Card # Signature Name on Card Check X____ = $_______ $_____________ Enter promo code for $50 discount on Clinical Lipid Update only _________________ 5 $750 Make checks payable to the NLA Exp. Date RD Other ____________________________ Registration: Registration and payment must be received no later than January 27, 2015. After this date a syllabus and name badge cannot be guaranteed. Cancellation: Telephone cancellations will not be accepted. A written notice of cancellation must be received no later than January 27, 2015. This includes social events and guest fees. There will be a $100 fee for all cancellations. Special needs: _______________________________ ________________________________________ ADA Compliance: Attendees who need additional reasonable accommodations or who have special needs should contact the NLA at 904.998.0854. *Master’s Course: To purchase the NLA-SAPs please go to: www.lipid.org/education/nlasap. †Trainee Rate: Available for those individuals actively enrolled in a graduate or postgraduate training program for the treatment or investigation of lipid disorders and in pursuit of full credentialing in their specialized area of medical study. A letter from the program director or the school registrar must accompany the application. Discount of $50 does not apply to Trainee Rate. Registration Discount Disclaimer: Discount codes cannot be retroactively applied to existing meeting registrations. The meeting discount codes are applicable to new registrants only. 3 Easy Ways To Register Mail National Lipid Association 6816 Southpoint Parkway, Suite 1000 Jacksonville, FL 32216 Fax NLA at 904-998-0855 Fax with credit card number and signature Online www.lipid.org/springclu Register Online at lipid.org /springclu