PURDUE VETERINARY MEDICINE
Check One:
SEPTEMBER 10 - 14, 2013 Purdue University Campus West Lafayette, IN
FALL CONFERENCE
□ Veterinarian □ Vet Tech / Non-PU Vet Tech Students □ Other Professionals-Aquatic Animal - Wednesday Only □ Shelter Medicine Staff - Friday Only □ Practice Managers-Professional Development - Thursday Only You can conveniently register online at www.vet.purdue.edu/fallconference.
(If you are not able to register online, mail and fax information is provided on the back of this form.) We ask that all Purdue Veterinary Medicine faculty, Emeritus faculty, staff, students, conference speakers and exhibitors register online.
Name _______________________________________ E-mail____________________________________ Address _______________________________________________________________________________ City _________________________________________________________ State ______ Zip __________ Degree(s) _____________________________________________________________________________ School(s) ______________________________________________________________________________ Year(s) ________________________________________________________________________________ Phone _______________________________________ Fax _____________________________________ Guest name (for nametag)__________________________________________________________________ Guest name (for nametag)____________________________________________________________________
Full Conference Registration Provides: •Shuttle Service •All Wednesday, Thursday and Friday Continuing Education Sessions •Thursday Medicine Mixer/Auction •Entrance to the Exhibit Hall •Complimentary refreshments during Wednesday, Thursday, and Friday Sessions
Additional Fees may be required for Special Events and Workshops. Please see each event for details.
Registration Options
Full Wednesday Conference Only
Veterinarians
Thursday Only
Friday Only
Late Fee after 8/26/13
$300
$175
$175
$175
$50
$
Retired Veterinarians (Retired and over 65) Vet Tech/ Non-PU Vet Tech Students
$150 $150
--$90
--$90
--$90
$50 $25
$ $
Retired Veterinary Technicians (Retired and over 65)
$75
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$25
$
Other Professional Staff / Practice Managers (Wed. or Thurs. Only) ---
$90
$90
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$25
$
Shelter Medicine Staff (Fri. Only)
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$30
$25
$
(Office Managers, Biologists, Regulatory, Research Scientists)
(Underwritten by Maddie's Shelter Program for shelter staff to attend)
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Special Events/Workshops/Meal Options (Space is Limited at Some of These Events - Be Sure to Register Early)
Wednesday, September 11
Box Lunch Indiana Vet Tech Assocation Luncheon Awards Celebration (General Reservation) Awards Celebration (Student Fee) Hands-On Fish Medicine
Additional Fees May Apply Cost $12.00 $14.00 $40.00 $15.00 $40.00
REGISTRATION CONTINUED ON BACK
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Total $ $ $ $ $