2008 AAI Advanced Course in Immunology Registration Form
Please complete the following information online, then print, SIGN, and submit the form by fax to
(301) 634-7733 or mail to: Advanced Course in Immunology, The American Association of Immunologists, Inc.,
9650 Rockville Pike, Bethesda, MD 20814. Please be sure to SIGN THE FORM before faxing or mailing.

Last Name* 

First Name*  

Title *  

Institution*  

Address  

Address  
Address  

City, State, ZIP  

Country  

Phone  

FAX  

E-mail address  

* Full name and institution will appear on name tag
I give permission for the above contact information to be printed in a course directory: Yes No
Special dietary request(s) Vegetarian    No Gluten    Kosher

REGISTRATION FEES -- Includes all course materials and coffee breaks.  Please check the applicable box:

$    590.  Graduate Student AAI Member**
$    640.  Graduate Student Nonmember**
$    725.  Postdoctoral Trainee AAI Member**
$    775.  Postdoctoral Trainee Nonmember**
$    890.  Regular Academic AAI Member
$    940.  Regular Academic Nonmember
$ 1,880.  Industry AAI Member
$ 1,930.  Industry Nonmember

** Must complete and submit AAI Trainee Certification Form (download here).

Enclosed total of amount checked above

***  PAYMENT (please check): Check Enclosed  Credit Card (Visa, Mastercard, American Express)
    Card Number   Expiration 
    Cardholder's Name (please print clearly)
    CARDHOLDER'S SIGNATURE (REQUIRED): _______________________________________________