Capitol Day 2025 Registration - Mississippi Academy of Family Physicians

Name
First Last
Member Type*
- MD
- DO
- Resident
- Medical Student
Medical School Attending*
Residency Program*
Parts of the Day You Plan to Attend*
- I am interested in Taking a Capitol Tour With a Guide
- Morning Meet and Greet in Rotunda
Number Attending MAFP Luncheon Feb. 4*
Box lunches will be ordered for those who RSVP to attend. The luncheon will be held at Galloway United Methodist Church, which is just South of the Capitol building – walking distance.
- 0
- 1
Please list any dietary restrictions you may have below:
Please Name Any MS Legislators You Know Personally
Email*
Mobile Number*
Personal Address*
We will use the address you provide to look up contact information for state legislators who represent you. We will provide this to you when you arrive on February 4.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Comments
This field is for validation purposes and should be left unchanged.