Fall Conference 2025 Registration Fall Conference 2025 Registration URLThis field is for validation purposes and should be left unchanged.Registrant Name(Required) First Last Please Choose One:(Required) MD DO NP Other Please click the box below if you are an AAFP Fellow with the designation 'FAAFP': FAAFP Please select one of the boxes below if you are a student or resident: Student Resident Clinic, Residency Program, or Medical School:(Required)Please click the box below if you are a first-time attendee:(Required) First Time Attendee I've Attended Before AAFP Member Number:ABFM Member Number: (If attending KSA)Address:(Required) Street Address City State / Province / Region ZIP / Postal Code Mobile Phone:MAFP use onlyYour Email:(Required) While at the conference, I will be staying overnight at:(Required) The Lodge at Gulf State Park using MAFP Group Rates The Lodge at Gulf State Park NOT using MAFP Group Rates Off Property REGISTRATION FEES:Registration Fee(Required)Active member fee is $425 and the Non-member fee is $600. KSA on Heart Disease will be $175. A 3% fee to accommodate our processing fees will be added. PLEASE CHOOSE THE REGISTRATION FEE THAT APPLIES TO YOUMAFP Member | $437.75NON- Member | $618.00Resident | $0.00Student | $0.00KSA $125 KSA Attendee Opt Out Select this option to register for the KSA on Heart Disease on Friday, October 17 at 1:30 PM. Spouse or Guest ($50.00 per guest) Quantity Price: $51.50 Quantity Spouse/ Guest Name First Last Consent As an attendee of the MAFP conference, I understand that my name and city will be included in the official attendee list. This list will be provided to exhibitors, sponsors and other registered attendees for networking and communication.Support the MAFP FamDocPACSelect Your FamDocPAC Contribution LevelPease note that the prices will incur a 3% fee to accommodate our processing fees. $50 PAC Contribution $100 PAC Contribution $250 PAC Contribution $500 PAC Contribution $750 PAC Contribution $1000 PAC Contribution MAFP FOUNDATION FUNDRAISER ITEMSFunds will be used for Foundation Physician Workforce Projects for Students and Residents. Watercolor Print (Signed & Numbered) Quantity(Special price for Fall Conference attendees) Price: $51.50 Quantity Sponsor a Student - $25 Quantity Price: $25.75 Quantity Oyster Art Experience During the Friday Night Reception QuantityFriday October 17th - In this creative and relaxing workshop, participants will transform real oyster shells into beautiful, decorative keepsakes. Using paint, gold leaf, and other artistic touches, you'll craft unique pieces perfect for gifting or displaying at home. No artistic experience needed, just bring your creativity and enjoy good company, coastal inspiration, and a little sparkle. Our thanks to Dr. Paul Pavlov for donating MS oysters for this Foundation project. $25 per creator Price: $25.75 Quantity MAFP Golf PoloMENS Navy PoloWOMENS Pink PoloWOMENS Light Blue PoloMAFP HatBlack Nike HatPink Nike HatWhite Nike HatMAFP SweatshirtGreyNavyPowder BlueWhiteMAFP Half Zip PulloverNavy MENS PulloverNavy WOMENS PulloverMAFP T-ShirtForest Green TshirtGrey Tshirt"Katie Coral" TshirtKelly Green TshirtNavy Blue TshirtPowder Blue TshirtWhite TshirtT- Shirt Quantity1234Shirt SizeSmallMediumLargeXL2XL3XLSelect from the Drop Down PAYMENTTotal Credit Card(Required) Product Name Quantity Price: $0.00 Quantity OptionFirst OptionSecond OptionThird Option Δ
