Event Registration System

Members should login here to fill most of the required fields and take advantage of the member prices. For free members events, please use the option - mail check to submit your event registration, event though no payment is required.

Event Registration & Details

Event Name	Event Date	Event Place
2010 Winter Gala Event	12/4/2010	Not available
From 12/4/2010 - To 12/4/2010 6:0:PM To 11:0:PM , Saturday

Log In � I know my user ID & password

Login Name :
Password :

Forgot ID/Password? Click Here

Register me � I don�t know my ID & password Or I am new to WAPI

First Name * :

Last Name * :

Email :

Specialty :

Phone * :

Attendees	No	Price Per Person	Total	Remarks
Member-WAPI
Member�s Spouse
Guest(Non-Physician)
Physicians(Non-member)
No. of Kids 13 & Over
No. of Kids 12 & Under
	Net Total

	Pay now(enjoy 10% discount)
	Pay at the door
	There is no payment due with this registration

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