North Dakota Academy of Family Physicians

Click Here for the mail in form.

	Before Dec. 1	After Dec. 1
North Dakota AFP Members:	$475	$525
All other physicians, FNP's, PA's, RN's and other Specialities	$550	$600
Residents outside ND*	$325	$375
North Dakota Residents & All Medical Students**	N/C	N/C
* - Out of State Residents please send a letter from the program director to verify your enrollment ** - ND Residents and Medical Students please register to assure accurate counts

Meals and Special Events
Please note if you and guest/children will be attending any of these events.

Tuesday Late Afternoon Movie

How many additional adults will be joining you at the movie?

How many additional children will be joining you at the movie?

Thursday Evening Dinner

Check here if you, the attendee, will be going to the dinner

How many additional adults will be joining you? ($10 for each additional adult)

How many additional children will be joining you? ($5 for each child (age 5-15))

Accepting Visa and MasterCard and Discover at this time.
Be sure to use the credit card blling address on the following page.