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AIM Exhibitor Registration Form

 

2013 AIM Annual Meeting Exhibitor Online Registration Form


Wednesday, April 17, 2013- Boston, Massachusetts


Please make checks payable to: Administrators in Medicine

EXHIBITOR FEE: $750

AIM Federal ID Number:  74-2329314         

Mail to:

Administrators in Medicine (AIM)
c/o Operations Management
PO Box 403
Augusta, ME 04332

Name(s) of Company Representative(s):

Dollar amount submitted with this form: $  Fee is $750.00

The first three lines of this information will be used for your name badge:

Name:  
Title:  
Company:  
Address:  
City:  
State:  
Zip:  
Email Address:  
Telephone: