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ONLINE REGISTRATION

10th Annual AACU State Society Network

State Advocacy Conference
October 20 – 21, 2017
The Westin Chicago O’Hare
Rosemont, Illinois


Online registration will be available until October 10, at 12:00 p.m. CDT.
After that date, on-site registration will be available.

Registration fees are subject to change.
  • Please select the category that best describes your status:*

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Industry Registration
For information about attending or sponsoring the AACU State Society Network, please contact JP Baunach in the Industry Relations Department at (847) 264-5942 or by email at jp@wjweiser.com.

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Registrant Information

  • First Name:*
  • Last Name:*
  • Degree(s):
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  • Address 1:*
  • Address 2:
  • City:*
  • State:*
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Meeting Registration*

  • Registration Categories
  • Regular Fees
  • Complimentary
  • Complimentary
  • $100
  •  (2018 Membership Included)
  • $300
  • Will you be attending the Pre-Conference Topical CME on Friday, October 20?*

Additional Tickets

Additional Evening Function Tickets for Non-Registered Guests:
One ticket is included with registration. Please only purchase if you plan on bringing additional guests to the dinner.

  • AACU Annual Dinner
  • # of tickets =
  • at $90 per ticket

  • TOTAL REGISTRATION FEE:

The AACU requires payment for registration fees by check or credit card.

Payment Information (must be made in U.S. dollars)

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  • Expiration Date: (mmyy)*
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If paying by check, make check payable to: AACU.

Mail payment to:
American Association of Clinical Urologists, Inc.
ATTN: Registration
Two Woodfield Lake
1100 East Woodfield Road, Suite 350
Schaumburg, IL 60173-5116

  • Enter Security Code: 9941
Registration Cancellation and Refund Policy

Nonmember paid registration refund requests will be subject to a $25.00 processing fee.

American Association of Clinical Urologists, Inc.
1100 E. Woodfield Rd. Suite 350 • Schaumburg, IL 60173 • Phone: (847) 517-1050 • Fax: (847) 517-7229

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