Southern Psychiatric Association (SPA) & Kentucky Psychiatric medical Association (KPMA) Annual Meeting Registration August 21 – 24, 2019 Brown Hotel, 335 W. Broadway, Louisville, Kentucky Registration Information: DEADLINE FOR REGISTRATION: July 20, 2019 Name Address Phone Email Dietary Restrictions MEETING INFORMATION: Check all below that apply to you SPA / KPMA Physician (Gala Farewell Dinner Included) BEFORE May 15 $ 450 AFTER May 15 $ 495 Member in Training – Contact Miranda Sloane to register: msloan@kypsych.org Early Career Psychiatrists (1-3 yrs.) (Gala Farewell Dinner Included) $ 250 Non-Physicians - Note Discipline Below ________________________________ Gala Farewell Dinner $250 + $ 95 Non SPA/KPMA Member $ 510 Daily Rate - Note Date(s): ____________ (Gala Farewell Dinner Not Included) $ 185/Day Guest(s):_________________________ ________________________________ $ 195 x ____ (# guests) $_________ Trolley Tour, Saturday, August 24 at 2 p.m. ($25 per person) (Add all Checked Boxes) TOTAL: Please note if attending Gala on Saturday, August 24 and number attending: $ ______ # People _____ $_______ □ No □ Yes #: _____ HOTEL INFORMATION: Brown Hotel – Louisville, KY 502-209-7346 or https://www.phgsecure.com/IBE/bookingRedirect.ashx?propertyCode=SDFBH&group=08212019SPA&arrivalDate=08-20-2019&departureDate=08-26-2019&numberOfNights=5 Reserve Room by July 22, 2019 Dates: Aug 21 – 24, 2019 Identify yourself as associated with the Southern Psychiatric Association to receive the special rate of $ 179/night (plus applicable state and hotel service fees). THERE ARE A LIMITED NUMBER OF ROOMS AVAILABLE AT THIS RATE, SO PLEASE BOOK AT YOUR EARLIEST CONVENIENCE. Questions: Call Janet Bryan at 410-938-3452 Please enclose check for total registration amount, payable to Southern Psychiatric Association and mail to address below: Janet Bryan, Executive Director Southern Psychiatric Association 6501 North Charles Street Baltimore, MD 21204