CO ACEP Registration Form 9-3-2024 Personal Information First Name * Last Name * Email * Address Address Line 1 Line 1 Line 2 Line 2 City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Registration Options * Leadership Symposium, November 14th, 1pm -5pm High Risk – Do Not Miss, November 15th, 8am - 5pm Full 2-day Conference Leadership Symposium, November 14th, 1pm -5pm: CO ACEP Member - $150 Non-CO ACEP Member - $200 Resident/Student- $50 APP- $200 High Risk – Don Not Miss, November 15th, 8am - 5pm: Morning Lectures Only, CO ACEP Member - $100 Morning Lectures Only, Non-CO ACEP Member- $200 Morning Lectures Only, Resident/Student - $50 Morning Lectures Only, APP - $200 Ultrasound Skills Only CO ACEP Member - $250 Ultrasound Skills Only, Non-ACEP member - $350 Ultrasound Skills Only, Resident/Student - $150 Ultrasound Skills Only, APP - $350 Full Conference (Leadership Symposium, CME lectures, Hands-on ultrasound Skills) Full 2-day conference, CO ACEP Member - $400 Full 2-day conference Non-CO ACEP Member - $600 Full 2-day conference Resident/Student - $200 Full 2-day conference, APP - $600 Registation total * Payment * Captcha Submit If you are human, leave this field blank.
