Home About Us Events & Announcements Annual Meeting Meeting Information Online Registration Hotel Information Travel & Transportation Evening Functions Accreditation Needs & Objectives Searchable Program Schedule Past Meetings Advocacy Member Directory Membership Application Links Contact Us Online Registration Wisconsin Rheumatology Association 2019 Annual Meeting March 8 – 9, 2019 The American Club Resort Kohler, Wisconsin The deadline for discounted early registration is February 4, 2019. After February 4, 2019, regular registration fees will apply to online and on-site registration. Online registration will be open through Feburary 28, 2019. After this date, on-site registration will be available. Registration Fees are subject to change. To lock in these rates, register now! Please select the category that best describes your status: Select One 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 One 2018 2019 2020 2021 2022 2023 2024 2025 Please Check ALL Areas of Practice Emphasis: (Check all that apply) Ankylosing SpondylitisPsoriatic ArthritisFibromyalgiaRheumatoid ArthritisGoutSclerodermaLupusSjogren’s SyndromeOsteoarthritisDoes Not Apply How did you learn about this conference? (Check all that apply) EmailMember NewsletterRegistration Brochure MailerCalendar/Monthly ListingWebsiteAdvertisement in Professional JournalWord of Mouth/Colleague Are you a member of the American College of Surgeons (ACS)?: YesNo To expedite CME processing, please enter your ACS member ID: Registrant Information Address Type: HomeOffice Meeting Registration Registration Categories Early Discounted through 2/4/2019 Regular Fees after 2/4/2019 Physician $50 $75 Non Physician Provider $25 $50 Practice Managers $25 $50 Student $0 $0 Fellow $0 $0 Resident $0 $0 Industry Employee - Supporting/MSL Industry Employee whose company is already supporting WRA 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 WRA $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 WRA please contact Brittany Kallman in the Registration Department at (847) 264-5963 or by email at firstname.lastname@example.org. Do you plan to attend the Annual Banquet on Friday, March 8, 2019? YesNo Additional Tickets One Spouse or guest is welcome to attend both the Welcome Reception and Annual Banquet complimentary. Please pre-register as space is limited. SpouseGuest TOTAL REGISTRATION FEE: The WRA 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: Wisconsin Rheumatology Association Mail payment to: Wisconsin Rheumatology Association 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 WRA 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. This question is for testing whether you are a human visitor and to prevent automated spam submissions. Enter in the Following Security Code: 262585 Registration Cancellation and Refund Policy Registration refund requests must be submitted in writing to the WRA Executive Office no later than February 4, 2019. All refund requests will be subject to a $10 processing fee. No refunds will be made after February 4, 2019.