Meetings Meeting Information Registration Hotel Information Travel & Transportation Accreditation Needs & Objectives Program Schedule Rheumatology Association of Nevada Two Woodfield Lake 1100 E. Woodfield Road Suite 350 Schaumburg, IL 60173 (847) 517-7225 (847) 517-7229 email@example.com SIGN UP FOR OUR MAILING LIST Managed by WJ Weiser & Associates, Inc. Registration Rheumatology Association of Nevada RAN 5th Annual Meeting April 25, 2020 Planet Hollywood Las Vegas Las Vegas, Nevada Online Registration will be available through Tuesday, April 14, 2020. After this date, on-site registration will be available. Please select the category that best describes your status: -- Select -- Industry Employee Fellow Full Time Administrator Nonphysician Provider Other Other Medical Professional Physician Researcher Resident Rheumatologist Student/Trainee Fellowship/Residency Program: Expected Graduation Year: -- Select -- 2019 2020 2021 2022 2023 2024 2025 How did you learn about this conference? -- Select -- Calendar/Monthly Listing Email Registration Brochure Mailer Please Check ALL Areas of Practice Emphasis: (Check all that apply) Ankylosing SpondylitisPsoriatic ArthritisFibromyalgiaRheumatoid ArthritisGoutSclerodermaLupusSjogren’s SyndromeOsteoarthritisDoes Not Apply RAN Membership Dues (Join or Renew Today) and attend the RAN 5th Annual Meeting complimentary! MEMBERSHIP APPLICATION *Nevada practitioners, if you pay the membership fee, you may register for the meeting complimentary. I am applying for membership as a: Physician $50 Nonphysician Provider $25 Registrant Information Address Type: HomeOffice Meeting Registration Registration Categories Fees Member Physician Complimentary Nonmember Physician $50 Member Nonphysician Provider Complimentary Nonmember Nonphysician Provider (e.g. RN, NP, Practice Manager) $25 Fellow Complimentary Resident Complimentary Student Complimentary Industry Employee - Supporting/MSL Industry Employee whose company is already supporting RAN OR Industry Medical Science Liaison (Proof of MSL Title may be required before confirmation of registration) $175 Industry Employee - Non-Supporting Industry Employee whose company is NOT already supporting RAN $1,250 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 RAN please contact Brittany Gyuricza in the Registration Department at (847) 264-5963 or by email at firstname.lastname@example.org. TOTAL REGISTRATION FEE: The Rheumatology Association of Nevada requires full payment for registration fees 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: Rheumatology Association of Nevada Mail payment to: Rheumatology Association of Nevada 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 RAN 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 in the Following Security Code: 671674 This question is for testing 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 RAN Executive Office no later than 4/3/2020. All refund requests will be subject to a $5.00 processing fee. No refunds will be made after 4/3/2020.