BMCAA Orlando Convention 2007

November 22 – 25, 2007

Make it a Family Convention

~for you, your spouse, children, grandchildren, friends & family~

EARLY REGISTRATION FOR ORLANDO CONVENTION

REGISTRATION FEES*

(Registration fee includes, CME courses and all scheduled meals/refreshments/entertainment)

Members, Spouse and Guest $430.00 per person

Children $230.00 per person

FEES ARE FULLY REFUNDABLE FOR CANCELLATION SUBMITTED BY October 1^st 2007

REGISTRATION INFORMATION:

Member Name: ______________________________________________________________________________

Last First Middle

Address: ______________________________________________________________________________

City State Zip

Phone: _____________________ Fax: _________________________ Email: __________________________

Attendees: Amount Due

1. Member Name: ____________________________________________________ $__________

2. Spouse Name: _____________________________________________________ $__________

Children Name: Age

1. _________________________________________________________ ____ $__________

2. _________________________________________________________ ____ $__________

3. _________________________________________________________ ____ $__________

4. _________________________________________________________ ____ $__________

Guest Name: Age

1. _________________________________________________________ ____ $__________

2. _________________________________________________________ ____ $__________

3. _________________________________________________________ ____ $__________

4. _________________________________________________________ ____ $__________

Total Amount Due: $_______________

MAKE CHECK PAYABLE TO BMCAA ORLANDO CONVENTION 2007 AND MAIL TO

MADHU PARIKH M.D

1519 OAKFOREST DR.

ORMOND BEACH, FLORIDA 32174

For more information contact Dr. MADHU PARIKH

E-MAIL BMCORLANDO2007@AOL.COM

Phone: 386-677-4411 Fax: 386-677-4111 Cell: 386-235-4001

For Hotel Registration Information

Windham orlando resort  is our convention hotel.to register for hotel,call 800-421-8001 and ask for baroda medical college alumni association rate(which is 99$ plus taxes).