How to Register Canceled or Closed Programs Step 1: Personal Information

How to Register
Canceled or Closed Programs
Step 1: Personal Information
Education programs may be canceled or closed due to capacity or
insufficient enrollment. If any selections are canceled or closed and
payment was made by credit card, the amount charged will include
only the available programs. If paid by check, a full refund will be
issued for affected programs. Allow four to six weeks after the
Annual Meeting for processing refunds.
Remove the mailing label on the back of this book and affix it to the
Personal Information box on the registration form. If the information on the
label is incorrect, make corrections on the label or in the space provided.
Cancellations/Refunds of Registration
Indicate your Primary Focus of Practice: Alzheimer’s Disease,
Amyotrophic Lateral Sclerosis, Attention Deficit-Hyperactivity
Disorder, Autism, Back Pain, Behavioral Neurology, Brain Tumors,
Carpel Tunnel Syndrome, Cerebral Palsy, Child Neurology, Chronic
Pain, Coma, Dementia, Dystonias, Epilepsy, Fibromyalgia, Headache,
Lyme Disease, Migraine, Movement Disorders, Muscular Dystrophy,
Multiple Sclerosis, Myasthenia Gravis, Neuropathy, Neuroimaging,
Parkinson’s Disease, Restless Legs Syndrome, Shingles, Sleep
Disorders, Spinal Cord Injury, Sports Concussion, Stroke, Sweat
disorders, Tinnitus, Tourette Syndrome, Traumatic Brain Injury, or
currently not in practice.
Until March 16, 2011 . . . Refund less $50 administrative fee
March 17–April 1, 2011 . . Refund less $100 administrative fee
After April 1, 2011 . . . . . No refund
All cancellations must be submitted in writing to
[email protected] or fax to (415) 293-4071.
No-shows will not receive a refund.
Name substitutions are not permitted.
No refunds will be processed for amounts of $20 or less.
Credit card refunds will be processed 4–6 weeks after request.
Check refunds will be processed 4–6 weeks after Annual Meeting.
Programs are subject to cancellation if enrollment is insufficient.
In the event of cancellation, registration for the cancelled
course will be fully refunded.
The AAN is not responsible for airfare, hotel, or other costs incurred
by participants in the event of program or registration cancellation.
Special Accommodations Deadline: March 16
The Hawaii Convention Center and the AAN are in compliance with
the Americans with Disabilities Act or Human Rights Code and strive
to accommodate all visitors. Information booths, designated parking,
and assisted listening devices are available. If you require special
accommodation to attend the Annual Meeting, contact Lori Strachota
no later than March 16, 2011, at [email protected] or (651) 695-2706.
Note: Kosher meals can be provided at any breakfast or lunch,
and must be arranged on or before March 16, 2011, by contacting
AAN Registration/CMR at [email protected], (800) 676-4226, or (415)
979-2283. There is a $25 surcharge per meal. On-site requests cannot
be accommodated.
Save Up to $600*
in Annual Meeting Registration!
Only an AAN membership can save you up to $600*on 2011
Annual Meeting registration and course fees—that’s nearly
the cost of your AAN membership dues alone! Plus you’ll get
all of the other benefits throughout the year that only an AAN
membership can afford. Visit today.
*Based on Active member status and early registration vs. on-site registration.
Note: It is important that this information be current. A confirmation
letter will be emailed or faxed. Name badge, tickets, and CME
transcripts will be mailed to the address provided.
Step 2: Education Programs and
Specialists in Focus
Shade the boxes corresponding to the Education Program type you
wish to register and enter the program number on the line.
Step 3: Fees
Box A: General Registration Fee: Select the appropriate fee. See
page 124 for fee inclusion details.
Box B: Education Program Fees: Calculate the total fees using the
Education Program Fee Schedule.
Box C and Box D: Virtual Annual Meeting and Additional
Activities (optional): Select a Syllabi on CD, Webcast-On-Demand,
and/or Practice CD. Price includes applicable sales tax. If you do not
pick up your CD at the AAN Store during the Annual Meeting, there
will be an additional $15 shipping and handling charge.
Step 4: Commercial Mailings
Registrant’s mailing and email addresses will be used for AANgenerated hard copy mailings and emails related to the Annual
Meeting and provided to commercial entities. Check the box if you
do not wish to receive hard copy mailings, invitations, and emails
from commercial entities.
Step 5: Payment
Indicate method of payment. Note: Government credit cards are not
accepted for advance registration, as they cannot be processed without
the actual credit card. Government credit cards may be used on-site.
Deadline: March 16
Registrations will be processed according to the date of receipt.
Registrations received after March 16, 2011, will be processed at a
higher rate. On-site registration opens Friday, April 8, 2011, at
3:00 p.m. at the Hawaii Convention Center.
(800) 676-4226
(415) 979-2283
[email protected]
Registration Worksheets
Education Program Fee Schedule
Use this table to calculate the fees for the number of registered programs. Tally the number of each type of program. Multiply the amount by the
fee for your membership type. Transfer the total amount to Box B on the registration form.
Note: Do not use this schedule for on-site registration. Neurologist member and nonmember fees increase $20.00 per program on-site.
Program Type:
Junior and
Non-Neurologist Member:
Member Neurologist:
(Honorary, Senior, Fellow, Active, Associate)
(Junior, Intern, Research Scientist, Non-neurologist
Clinician, Business Administrators, Students)
Corresponds with “2.0 Education Program” on registration page 127
AC/PC (Half-Day Course)
x $45 = x $115 = x $145 = CS (Case Studies Program)
x $75 = x $110 = x $150 = EP* (Directors Conference)
x $125 = x $255 = x $385 = ES (Extended Seminar)
x $75 = x $110 = x $150 = FC (Full-Day Course)
x $90 = x $225 = x $280 = KP (Kick-Off Program)
x $50 = x $80 = x $105 = MR (Morning Report)
x $60 = x $85 = x $115 = NF (Neuro Flash)
x $60 = x $85 = x $115 = NP (Neurology Skills Pavilion)
x $180 = x $235 = x $315 = PM***
(Post Meeting Neuroimaging Conference)
x $235 = x $440 = x $525 = PW (PM Skills Workshop)
x $180 = x $235 = x $315 = SC** (Science Conference)
x $100 = x $155 = x $210 = SM (Seminar)
x $60 = x $85 = x $115 = SW (Skills Workshop)
x $350 = x $460 = x $615 = Corresponds with “2.1 Specialists in Focus Tracks” on registration page 127
Specialists in Focus:
Aging/Dementia/Degenerative Disease
x $85 = x $220 = x $280 = Specialists in Focus: Cerebrovascular
x $85 = x $220 = x $280 = Specialists in Focus: Child Neurology
Specialists in Focus:
Movement Disorders
x $85 = x $220 = x $280 = x $85 = x $220 = x $280 = Total Education Program Fees (Enter in Box B on Registration Form): ______________________________
* If you are attending the Clerkship and Program Directors’ Conference (1EP.001) only and no other Annual Meeting events, the cost increases $50.
** If you are attending the Future of Neuroscience Conference (7SC.001) only, and no other Annual Meeting events, the cost increases $70 ($170 on-site) and includes
Thursday and Friday Scientific events. Medical students and PhD candidates may attend at no charge but MUST register and receive a ticket.
***If you are attending the Post Meeting Neuroimaging Conference and no other Annual Meeting events, the cost increases $50. The cost increases $40 on or after March 17, 2011.
Corresponds with “3. Fees” section, Box C on registration page 127
LD (Physician Leadership Program)
x $90 = x $225 = x $280 = 2011 Virtual Annual Meeting Product Fees
Use this table to calculate the fees for Virtual Annual Meeting products. Tally the number of each type of product. Multiply the amount by the fee
for your membership type. Transfer the total amount to Box C on the registration form.
Corresponds with “3. Fees” section, Box D on registration page 127
Program Type:
Virtual Annual Meeting Three Pack
(Webcast, Syllabi, and MP3)
Virtual Annual Meeting Two-Pack
(Webcast and Syllabi)
Junior and
Non-Neurologist Member:
Member Neurologist:
After March 16
x $199 = x $299 = x $499 = x $1,099 = x $129 = x $199 = x $299 = x $849= Syllabi CD
x $49= x $99 = x $149 = x $299= Practice CD
x $39 = x $49 = x $59 = x $99= Webcast-On-Demand
x $99 = x $149 = x $199 = x $599= MP3-On-Demand and DVD
x $99 = x $149 = x $199 = x $299 = Total Product Fees (Enter in Box D on Registration Form): ___________________
AAN 63rd Annual Meeting Registration Form / Deadline: March 16, 2011
1. Personal Information
AAN ID Number
One form per registrant
Primary Focus of Practice
2.1 Specialists in Focus Tracks (See page 17 for more information)
Saturday, April 9-Sunday, April 10
Specialists In Focus: Attending  _________
Aging/Dementia/Degenerative Disease
(Includes 1PC.002, 2PC.006, and Integrated Neuroscience Session).
Name (last, first, middle initial) and degree (MD, DO, PhD, RN)
Sunday, April 10-Monday, April 11
ZIP/Postal Code
Specialists In Focus: Cerebrovascular Attending  _________
(Includes 2AC.007, 3AC.006, and Integrated Neuroscience Session).
Sunday, April 10- Monday, April 11
Specialists In Focus: Child Neurology Attending  _________
(Includes 2PC.007, 3PC.007, and Integrated Neuroscience Session).
2.0 Education Programs
There is a fee for each selected Education Program. Calculate the total in the Education
Program Fee Schedule on page 126 and enter in Box B in the Fees section. To register
for a program, shade the box and enter the complete number of the program on the line.
Saturday, April 9, 2011
 1AC.  1EP.  1FC. Sunday, April 10, 2011
 2AC.  2ES.  2ES.  2FC. Monday, April 11, 2011
 3AC.  3CS.  3CS.  3ES. Tuesday, April 12, 2011
 4NP.  4PC.  1KP.  1NP.  1PC. I will be attending this day  1SM.
 1SM.
 1SM.
 2NF.  2NP.  2PC. I will be attending this day  2PW.  2SM.  2SM.  3ES.  3FC.  3MR.  3NP. I will be attending this day  3PC.  3SM.  3SM.  3SW.  4SM.  4SM. Wednesday, April 13, 2011
 5CS.  5NP.  5NF.  5PC. I will be attending this day  4SM. I will be attending this day  5SM.  5SW. Thursday, April 14, 2011
 6NF.  6SM.  6PC.  6SM. I will be attending this day  6SM. Friday, April 15, 2011
 7AC.  7CS.  7ES.  7ES. I will be attending this day  7SM.  7SM.  7SW.  7FC.  7NF.  7PC.  7SC. Saturday, April 16, 2011
 8AC.  8SM. I will be attending this day  8PM. 001 (Post Meeting Neuroimaging Conference)
Monday, April 11-Tuesday, April 12
Specialists In Focus: Movement Disorders Attending  _________
(Includes 3AC.007, 4PC.004, and Integrated Neuroscience Session).
3. Fees
BOX A: General Registration Fee
Before March 16 After March 16
Student $0
$0 _ ________
Junior and Non-Neurologist Member $100
$130 _ ________
(Junior, Intern, Business Administrator,
Non-Neurologist Clinician, Research Scientist)
Member Neurologist $305
$420 _ ________
(Active, Associate, Fellow)
Member Neurologist $0
$0 _ ________
(Senior, Honorary)
Nonmember $610
$840 _ ________
BOX B: Education Program Fees
Calculated in program fee schedule on page 126 ��������
BOX C: Additional Opportunities (Check all that apply)
Physician Leadership Program  Monday  Friday
Celebration for Research Guest Tickets $50 ea.
(one free ticket per registrant)
Run/Walk for Brain Research $25 ea.
AAN and AAN Foundation Awards Luncheon
$50 ea.
(Junior Members and Students free upon request)
Support Research, Buy a Brain $5 ea.
_ ________
_ ________
_ ________
_ ________
BOX D: Virtual Annual Meeting (VAM)
____VAM 3-Pack ____VAM 2-Pack ____Syllabi CD ____Practice CD
____Webcast-On-Demand ____MP3-On-Demand & DVD
Calculated in product fees on page 126 ��������
Registrations received after March 16, 2011,
will be processed at higher rates.
TOTAL ���������
4. Commercial Mailings
 I do not wish to receive hard copy mailings, invitations, and emails from
commercial entities.
5. Payment
 Check/Money Order Payment must accompany registration. Make check
payable to American Academy of Neurology (US funds only). A $25 charge
will apply to checks returned for insufficient funds.
 VISA  Master Card  American Express  Diner’s Club
Card number: �����������������������������������������������
Mail: A
AN Registration/CMR
33 New Montgomery, Suite 1100
San Francisco, CA 94105
Expiration date: / No government credit cards.
(415) 293-4071
I authorize the AAN to charge my credit card the amount determined by the AAN as
registration fees.
Fed ID# 41-0726167AAN