2008 AAI Introductory 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: Introductory 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 it to AAI.

First Name*  

Last Name*  

Title *  

Institution*  

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 information to be printed in a course directory: Yes No
Special dietary request(s)  Vegetarian  No Gluten  Kosher
REGISTRATION FEE: Includes all course materials, daily continental breakfasts and coffee breaks, and box lunches where indicated.  Please indicate applicable selections:
Part I June 20-23  OR  Part II June 23-26 Parts I AND II June 20-26
$ 285.  Graduate Student AAI Member** $ 470.  Graduate Student AAI Member**
$ 365.  Graduate Student Nonmember** $ 550.  Graduate Student Nonmember**
$ 370.  Postdoctoral Trainee AAI Member** $ 580.  Postdoctoral Trainee AAI Member**
$ 450.  Postdoctoral Trainee Nonmember** $ 660.  Postdoctoral Trainee Nonmember**
$ 445.  Regular Academic AAI Member $ 720.  Regular Academic AAI Member
$ 520.  Regular Academic Nonmember $ 795.  Regular Academic Nonmember
$ 975.  Industry AAI Member $ 1,560.  Industry AAI Member
$ 1,055.  Industry Nonmember $ 1,640.  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): _______________________________________________