Registration Meetings Upcoming Meetings Meeting Information Abstracts Registration Hotel Information Travel & Transportation Social Events Accreditation Needs & Objectives Program Schedule Previous Meetings 72nd Annual Meeting of the Northeastern Section of the AUA October 1 - 3, 2020 The Westin Charlotte Charlotte, North Carolina The deadline for discounted early registration is Tuesday, September 8, 2020. After 9/8/2020, regular registration fees will apply to online and on-site registration. Online Registration will close on Monday, September 21, 2020 at noon CT. Registration fees are subject to change. To lock in these rates, register now! Please select the category that best describes your status: --Select-- Industry Employee Fellow Full Time Admin Nonphysician Provider Other Other Medical Professional Physician Researcher Resident Student/Trainee Urologist Urology Fellow Urology Resident Fellowship/Residency Program: Expected Graduation Year: --Select-- 2020 2021 2022 2023 2024 2025 How did you learn about this conference? --Select-- Advertisement in Professional Journal Calendar/Monthly Listing Email Member Newsletter Registration Brochure Mailer Website Word of Mouth/Colleague Please Check ALL Areas of Practice Emphasis: (Check all that apply) AndrologyOncologic Urology - KidneyBenign Prostatic DiseaseOncologic Urology - ProstateCalculus DiseaseOncologic Urology - PenileCryosurgeryOncologic Urology - RenalEndourologyOncologic Urology - TesticularFemale UrologyOncologic Urology - All formsFetal UrologyPediatric UrologyGeriatric UrologyReconstructive UrologyIncontinence - FemaleRenal TransplantationIncontinence - MaleRoboticsLaparoscopySexual Medicine - FemaleNeurourologySexual Medicine - MaleOncologic Urology - BladderDoes Not Apply Registrant Information Address Type: HomeOffice Meeting Registration Registration Categories Early Discounted through 9/8/2020 Regular Fees after 9/8/2020 NSAUA Member $400 $500 NSAUA Senior Member $375 $475 Nonmember Physician $500 $600 Advanced Practice Provider $300 $400 NSAUA Resident/Fellow/Medical Student $200 $300 Industry Employee - Supporting/MSL Industry Employee whose company is already supporting NSAUA OR Industry Medical Science Liaison $600 (Proof of MSL Title may be required before confirmation of registration) Industry Employee - Non-Supporting Industry Employee whose company is NOT already supporting NSAUA $975 Your submission will need to be approved prior to confirmation of your registration. Approval may be based on current Industry support. To find out if your company is currently supporting NSAUA please contact Brittany Gyuricza in the Registration Department at (847) 264-5963 or by email at firstname.lastname@example.org. Social Events Meeting registration includes (1) ticket for Fun Night, Exhibit Hall Brunch and President’s Reception & banquet. An RSVP is required for the social events. Will you attend Fun Night? --Select-- Yes No Will you attend the President’s Reception & Banquet? --Select-- Yes No Guest Registration Guest registration for full meeting includes (1) ticket for Fun Night and the President’s Reception & Banquet as well as a breakfast voucher each morning. Early Discounted through 9/8/2020 Regular Fees after 9/8/2020 Guest - Full Meeting 0 1 2 3 $325 $400 Guest 1 Guest 2 Guest 3 Registered Guest — Social Events Attendance Meeting registration includes (1) ticket for Fun Night and President’s Reception & Banquet. An RSVP is required for the social events. Will your guest(s) attend Fun Night? --Select-- Yes No Will your guest(s) attend the President’s Reception & Banquet? --Select-- Yes No Guest Tickets for Social Events ONLY All meeting registrations include one (1) ticket for each social event. Please only purchase additional tickets if you are not registering a guest for the entire meeting. Early Discounted through 9/8/2020 Regular Fees after 9/8/2020 Guest Ticket for Fun Night 0 1 2 3 $100 $125 Child Ticket for Fun Night (12 and under) 0 1 2 3 $50 $75 Guest Ticket for the President’s Reception & Banquet 0 1 2 3 $100 $125 TOTAL REGISTRATION FEE: The NSAUA requires full payment for registration fees and optional activities by check or credit card. Payment Information (must be made in U.S. dollars) CheckCredit Card --Select Card-- Visa MasterCard American Express If paying by check, make check payable to: Northeastern Section of the AUA, Inc. Mail payment to: Northeastern Section of the AUA, Inc. Two Woodfield Lake 1100 E. Woodfield Road, Suite 350 Schaumburg, IL 60173 I have read, understood and agree to the electronic delivery of the data collected and payment amount. SIGNATURE: By selecting “I Agree” I represent and acknowledge that: I have read, understood, and consented to electronic delivery of the data collected and payment entered above. I have granted authorization to NSAUA in association with WJ Weiser & Associates, Inc. to charge the amount indicated on the credit card provided. I am the authorized user of the credit card listed above and that the associated information entered (account holder name, account number, billing address, etc.) is accurate. I intend the act of selecting “I Agree” to be my legal signature to this agreement. Enter Security Code: 891192 This is to test whether you are a human visitor and to prevent automated spam submissions. Registration Cancellation and Refund Policy Registration refund requests must be submitted in writing to the NSAUA Executive Office by 9/17/2020. All refund requests will be subject to a $100 processing fee. No refunds will be made after 9/17/2020.