Attendee Conference Registration Form
Updated April 2009
June 7-11, 2009 • Ft. Lauderdale Convention Center •Ft. Lauderdale, FL
 Check here if you do not wish to be included
in promotional mailings from APIC Exhibitors
Step I – Attendee Registration
sent prior to APIC 2009. Promotional mailings
often include special exhibitor-sponsored
(Required for membership events and reception invitations. The APIC
APIC Member ID# SHEA Member ID# CHICA Member ID#
discounts) 2009 mailing list is limited to a one-time use
only and does not contain phone, fax, or email.
Not an APIC member? Join now to receive conference discounts.
Instructions
 Yes, I want to become an APIC member: U.S. Citizen: $175.00 International: $195.00
1. Please print all information.
(If already a member, enter $0.00) Total Step I $
2. Use separate form for each attendee
registration.
3. Payment must be in U.S. dollars.
Last Name First Name MI Nickname for Badge
4. Payment must accompany all registrations (NO
exceptions).
Title Credentials Company/Employer Name 5. Payment may be made by check, payable
to APIC, or by American Express, VISA, or
Preferred Mailing Address  Home  Work
MasterCard.
6. Cancellation Policy: All cancellation requests
must be received by APIC Headquarters in
City State/Province Zip/Postal Code Country
writing (fax, email) prior to the start of the
conference on June 7th, 2009. An 80% refund
Phone Fax Email address (Required; confirmations will be sent via email) will be given if request is received prior to the
Early registration deadline (April 27, 2009). A
If you require special accommodations due to disability, health concerns or physical challenges please contact the
70% refund will be given if request is received
APIC conference manager at 703.964.1240 ext. 14 or APICConferenceManager@conferencemanagers.com
after April 27, 2009 but before May 25,
2009. Please submit cancellation requests to
Step II – Conference Registration *APIC is going green. There will be no hardcopy handouts for the full conference.
education@apic.org or fax to 202.789.1899.
There will be no refunds for cancellations
Optional events in steps III - VII are NOT included in any conference registration package and must be purchased separately.
received after May 25, 2009. No-shows are
One day registration can only be used for ONE day; two or more days require full conference registration.
non-refundable.
Regular
Early April 27 –
7. Pre-Conference and Workshop Cancellations: All
Check the box next to your selection By April 27 June 1 On site Total cancellations for pre-conference or workshops
1.

Member (Full registration) $520 $620 $670 $
will be processed after the annual conference.
Please note that no cancellations will be
2.

Non-Member (Full registration) $820 $920 $970 $
accepted for meet-the-expert tickets.
8. Program Cancellation: In the unlikely event of
3.

Student (Full registration) Student ID required at check-in $150 $200 $200 $ conference cancellation, APIC will refund 100
percent of registration fees paid. APIC assumes
4.

One Day, Member (circle day)
$295 $295 $295 $
no liability for any penalty fees on airline
•Mon •Tues •Wed •Thurs
tickets, deposits for hotel accommodations,
or any other fees, charges, penalties, or other
5.

One Day, Non-Member (circle day)
$410 $410 $410 $
incidental costs that a registrant might incur as
•Mon •Tues •Wed •Thurs
a consequence of cancellation.
6.

Exhibits and Opening Reception
$40 $40 $40 $
Included in registration, but may be purchased separately Register Online at www.apic.org
Or send completed form and final payment
Total Step II $
to: APIC 2009
c/o Laser Registration
Step III – Pre-Conference Workshops *Hardcopy handouts available for items 1-13 only.
1200 G Street, NW
Suite 800
Programs listed below are NOT included in any conference registration Attendee Member Non-Member
package. Please note that 2-day and ½-day courses overlap.
Washington, DC 20005-3967
Limit Early/Regular Early/Regular Total
Fax: 514-380-5395
Saturday, June 6 & Sunday, June 7 2-Day Courses
(Must include credit card number for pay-
1. Certification Review Course Sat & Sun: 8am–5pm 275 $320/$380 $510/$570 $ ment)
2. Estimating the Financial Impact of HAIs Sat: 8am–5pm
 To avoid duplicate charges, please
50 $320/$380 $510/$570 $
(Hands on) Sun: 8am–12pm either mail or fax your registration –
DO NOT DO BOTH.
Saturday, June 6 1-Day Courses
For additional information, contact Confer-
3. Disinfection, Sterilization and Antisepsis:
8am–5pm 275 $220/$410 $280/$470 $ ence Registration at 514-380-5394 or
Principal, Practices, Current Issues...
apic@laser-registration.com
Sunday, June 7 ½-Day Course
Be sure to complete both sides of this
4. Microbiology 101 8am–12pm 150 $150/$180 $245/$275 $
registration form.
Total Step III $
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APIC 36th Annual Educational Conference & International Meeting Preview
26 Visit www.apic.org for updates
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