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Annual Conference
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Supporters
Photo Gallery
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SCOOP
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Elections
Contact
Conferences
CLICK HERE FOR CONFERENCE BROCHURE
CLICK HERE TO BOOK YOUR ROOM
2024 Conference Registration
Name
*
First
Last
Address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Email
*
Institution
*
License No.
*
Are You a Member of APHON?
*
Yes
No
APHON #
*
If you don't remember,
please contact APHON.
Expiration
*
If you don't remember,
please contact APHON.
Please upload your APHON Membership. ***TO GET A COPY OF YOUR ACTIVE APHON MEMBERSHIP, LOG IN TO APHON.ORG. ONCE LOGGED IN, CLICK MY APHON AND YOU ARE ABLE TO PULL UP YOUR MEMBERSHIP CARD; PLEASE DO NOT ATTACH YOUR CHEMOTHERAPY AND BIOTHERAPY PROVIDER CARD***
*
Are you a Current Member of SCAPHON?
*
Yes
No
Please upload your Scaphon Membership
*
You can become a SCAPHON Member and save on the conference!!! Last day to sign up is March 31st, 2023. Membership is $30 annually from January 1st - December 31st. Enjoy all the perks of being a SCAPHON Member each year. You MUST be an APHON Member and live in the Southern California area to become a SCAPHON Member. Membership is not prorated. To sign up and for membership details, click on our membership tab or go to
https://www.scaphon.org/membership/.
SCAPHON Member: Will you be attending 1 Day or 2 Days?
*
Please Select
One Day-Scaphon Members
Two Days-Scaphon Members
APHON Members: Will you be attending 1 Day or 2 Days?
*
Please Select
One Day-Aphon Members
Two Days-Aphon Members
Non-Members: Will you be attending 1 Day or 2 Days?
*
Please Select
One Day-Non-Members
Two Days-Non-Members
Which day?
*
June 6th
June 7th
Total
$0.00
*PLEASE READ CAREFULLY*
A $10 PayPal fee has been added to your online payment registration for the 2024 SCAPHON Conference.
The PayPal email you will receive is your receipt.
After clicking submit, on the payment page, you do not need to have a PayPal account to make a payment, you can scroll down and use a credit card or a debit card to pay. Online registration deadline is May 27, 2024. After this date there will a $25 late fee added to your registration (mail in or in person registrations only). NO REFUNDS after May 27, 2024.
For questions, please contact Deborah Marino, Conference Planning Chair:
dmarino@chla.usc.edu
