REGISTRATIONFORM
2009 FDA/Industry Statistics Workshop
Sponsored by the ASA Biopharmaceutical Section with cooperation from the FDA Statistical Association
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INSTRUCTIONS
1. Print or type all information and retain a copy for your records.
2. Use a separate form for each registrant.
3. Mail form with payment to FDA/Industry Statistics Workshop Registration, P.O. Box 221,
Annapolis Junction, MD 20701. Fax form (credit card only) to (301) 206-9789.
www.amstat.org/
4. Registration form must be received by August 26, 2009, to be processed at the reduced rate.
meetings/fdaworkshop
Forms Received Without Payment Will Not Be Processed.
ATTENDEE INFORMATION MEAL PREFERENCE Lunch on Thursday, September 24, and
Friday, September 25, is included with your workshop registration.
To assist in planning, please select the area of discussion that most interests you.
Name
See Page 2 of this form for the list of topics.
3ELECTONEOFTHEFOLLOWINGMENUOPTIONSFOREACHDAY
Thursday, September 24 Friday, September 25
Preferred Name for Badge Topic:________________ Topic:________________
❑ Regular ❑ Regular
❑ Vegetarian ❑ Vegetarian
ASA ID # (if known)
❑ Not attending lunch ❑ Not attending lunch
(Regular=turkey sandwich; Vegetarian=veggie wrap) All boxed lunches include
Organization
chips, a piece of fruit, and a cookie.
REGISTRATION FEES Workshop Fee (required)
Address
By August 27–
August 26 September 15
❑ Registrant $270 $295 $__________
❑ Academic (nonstudent) $230 $255 $__________
❑ Biopharm Section Member $230 $255 $__________
City State/Province ZIP/Postal Code
❑ Government $130 $155 $__________
❑ Student $130 $155 $__________
Short Courses—7EDNESDAY, September 23
Country (non-U.S.)
Add-ons to Workshop Fee: $100 each before Aug. 27; $105 each Aug. 27–Sept. 15
8:00 a.m.–12:00 p.m.
Phone ❑ SC1: Adaptive Designed Clinical Trials—Martin Posch &
Sue-Jane Wang $__________
❑ SC2: Benefit: Risk Assessment—Scott R. Evans $__________
Email
❑ SC3: Analysis of Longitudinal Studies with Missing Data—
Diane Fairclough $__________
In case of emergency, list the name and phone number of the person
❑ SC4: Cox Regression in Practice—Brenda Gillespie $__________
we should contact (remains confidential).
1:00 p.m.–5:00 p.m.
Emergency Contact’s Name _____________________________________________
❑ SC5: Special Topics in Survival Analysis—Lee-Jen Wei $__________
Relationship to Registrant ______________________________________________ ❑ SC6: Bootstrap Methods and Permutation Tests—
Tim Hesterberg $__________
Telephone Number ____________________________________________________
❑ SC7: Recent Advances in Bayesian Adaptive Methods for
❑
Clinical Tests—Peter F. Thall $__________
Check here if you would like your ASA customer contact
information updated with your meeting contact information.
❑ SC8: Data Monitoring Committees—Tom Fleming &
Janet Wittes $__________
This meeting is ADA accessible.
TOTAL FEES: $_________
❑ Please check here if you need special services due to
a disability and attach a statement regarding your needs. PAYMENT
❑ Check/money order payable to the American Statistical Association
CANCELLATION POLICY
(in U.S. dollars on U.S. bank)
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JUNE 2009 AmstAt News 51
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