1. Southern Psychiatric Association (SPA) & Kentucky Psychiatric medical Association (KPMA) Annual Meeting Registration
August 21 – 24, Brown Hotel, 335 W. Broadway, Louisville, Kentucky
Registration Information:
DEADLINE FOR REGISTRATION: July 20, 2019
Name
Address
Phone
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:
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 or
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
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