WA/OR ACS 2025 Registration Form
Name
*
First Name
Last Name
Institution
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Are you bringing guest(s) to the meeting? Please write their name below. Names and ages for the kids
ACS Chapter Membership
Washington State
Oregon
N/A
Other
Registration Options
Meeting Registration
Categories:
All
All
Registration (includes all meals)
Social Event Fees (for guests)
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Registration (includes all meals)
ACS Fellow
$
300.00
Retired Member, PA, RN, Office Staff
$
200.00
Non-member MD
$
350.00
Trainee
$
150.00
Medical Students
$
50.00
Invited speaker (not abstract presenter)
$
Free
Social Event Fees (for guests)
Spouse/Guest/Children over 18
Includes welcome reception and annual banquet.
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Children 6-17
Includes welcome reception and Saturday Kids Program
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Children under 6
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Friday Welcome Reception Only
(For guests, if attending this event only)
$
60.00
Quantity
1
2
3
4
5
6
7
8
9
10
Saturday Annual Banquet Only
(For guests if attending this event only)
$
60.00
Quantity
1
2
3
4
5
6
7
8
9
10
Questions? Please email us at
admin@wachapteracs.org
or call 206-794-9174.
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