Big Sky Family Medicine Update Registration

Basic Info
AAFP ID
First Name^*
Last Name^*
Title/Designation
Address^*
City^*
State^*
Zip^*
Country^*
Phone
Email^*
Event Details
Event Fee^*		NDAFP Member - 3 Day - $500.00 NDAFP Members - 5 Day - $650.00 All other MDs, Dos - 3 Day - $550 All other MDs, Dos - 5 Day - $700 PA, NP, Retired MD, & Out of state Residents - 3 Day - $425 PA, NP, Retired MD, & Out of state Residents - 5 Day - $500 ND Students and Residents - 3 Day - Free ND Students and Residents - 5 Day - Free
Free Tuesday Afternoon Family Movie
Adults
Children