SOAP 49th Annual Meeting Registration Form
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May 10-14, 2017 •Hyatt Regency Bellevue • Bellevue, Washington

*Required

* Dr.   Mr.   Mrs.   Ms. SOAP Member ID #
ABA #
ASA Member ID #
*Badge Name (first name to appear on the first line of the badge)
*First Name: MI: *Last Name:
*Degree(s): *Specialty:
*Affiliation:  
(Organization)    
*Mailing Address:
*City:
*State/Province:
*Zip/Postal Code:
*Country:
*Business Phone: Cell Phone: Fax:
*E-mail Address: Twitter Handle:

Is this your first time attending the SOAP Annual Meeting?
Yes No

Which of the following best describes your medical practice environment? (Please select one)
Academia Consulting Hospital-based Large Group Practice
Private Practice Retired Other

Special Needs
I will require special accommodation (also contact the SOAP Administrative Office at info@soap.org or 414-389-8611)
Please check here for vegetarian meals
Please check here for kosher meals
Please check here for gluten-free meals

How did you hear about this meeting? (Please select one)
Email Announcement From Colleague Journal Ad SOAP Member
Another Society’s Website/Newsletter Other:


Registration Fees*

General Registration includes one ticket to the Welcome Reception, Continental Breakfasts, Breaks, Thursday Lunch and T-shirt.

SOAP Member Fees Early Discounted Rate
Through April 11, 2017
Advanced Reg Rate
Through April 26, 2017
ONSITE ONLY
After April 26, 2017
Amount
SOAP Member $695 $745 $795 $
SOAP Resident, Fellow, Student $495 $545 $595 $
SOAP Retired/Lifetime Members - Complimentary Registration*

*Please note, to qualify for this registration, you must be a SOAP Retired Member or Lifetime Member and have 20+ years of SOAP Membership.
      $
SOAP Non-Member Fees Early Discounted Rate
Through April 11, 2017
Advanced Reg Rate
Through April 26, 2017
ONSITE ONLY
After April 26, 2017
Amount
OASAO, OAA, SMFM, NASOM Member (SOAP Non-Member) $795 $845 $895 $
Non-Member $895 $945 $995 $
 
One Day Registration (Available onsite only)
Thursday, Friday, Saturday OR Sunday
    $350  

Special Registration Fees - Middle and Low Income Countries (World Bank Classification)

Attendees are eligible for ‘middle income country’ registration providing they meet all the following criteria:

  • Reside in a country in the ‘Middle and Low Income Countries’ category
  • Working (or previously working) in a country in the ‘Middle and Low Income Countries’ category
  • Have a postal address a country in the Middle and Low Income Countries’ category which is detailed at time of registration
SOAP Member and Non-Member Physician
  $495 $
SOAP Member and Non-Member Resident/Fellow/Student   $495 $

World Bank Classifications (2015)



Middle Income Countries*

Attendees are eligible for ‘middle income country’ registration providing they meet all the following criteria:

  • Reside in a country in the ‘middle income country’ category
  • Working (or previously working) in a country in the ‘middle income country’ category
  • Have a postal address a country in the ‘middle income country’ category which is detailed at time of registration
Albania
Algeria
American Samoa
Angola
Armenia
Azerbaijan
Bangladesh
Belarus
Belize
Bhutan
Bolivia
Bosnia and
Herzegovina
Botswana
Brazil
Bulgaria
Cabo Verde
Cambodia
Cameroon
China
Colombia
Congo, Rep.
Costa Rica
Côte d’Ivoire
Cuba
Djibouti
Dominica
Dominican Republic
Ecuador
Equatorial Guinea
Egypt, Arab Rep.
El Salvador
Fiji
Gabon
Georgia
Ghana
Grenada
Guatemala
Guyana
Honduras
India
Indonesia
Iran, Islamic Rep.
Iraq
Jamaica
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kyrgyz Republic
Lao PDR
Lebanon
Lesotho
Libya
Macedonia, FYR
Malaysia
Maldives
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia, Fed. Sts.
Moldova
Mongolia
Montenegro
Morocco
Myanmar
Namibia
Nicaragua
Nigeria
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Romania
Samoa
São Tomé and Principe
Serbia
Solomon Islands
South Africa
Sri Lanka
St. Lucia
St. Vincent and the
Grenadines
Senegal
Sudan
Suriname
Swaziland
Syrian Arab Republic
Tajikistan
Thailand
Timor-Leste
Tonga
Tunisia
Turkey
Turkmenistan
Tuvalu
Ukraine
Uzbekistan
Vanuatu
Venezuela, RB
Vietnam
West Bank and Gaza
Yemen, Rep.
Zambia


Low Income Countries

Attendees are eligible for ‘low income country’ registration providing they meet all the following criteria:

  • Reside in a country in the ‘low income country’ category
  • Working in a country in the ‘low income country’ category
  • Have a postal address a country in the ‘low income country’ category which is detailed at time of registration
Afghanistan
Benin
Burkina Faso
Burundi
Central African Republic
Chad
Comoros
Congo, Dem. Rep.
Eritrea
Ethiopia
Gambia, The
Guinea
Guinea-Bissau
Haiti
Korea, Dem. Rep.
Liberia
Madagascar
Malawi
Mali
Mozambique
Nepal
Niger
Rwanda

Sierra Leone
Somalia
South Sudan
Tanzania
Togo
Uganda
Zimbabwe

* T-Shirt (included in registration fee) Please indicate size:
Small   Medium   Large   XL   XXL   I do not want a t-shirt
  Additional shirts may be purchased onsite for $10 while quantities last.
   
Guest(s) Registration Fee       Amount
General Adult Guest Registration        
General Adult Guest Registration includes one ticket to the Welcome Reception and a t-shirt Number of adult guest(s) x $150 $
 
Name(s) of spouse/adult guest(s)
 
T-Shirt (included in registration fee) Please indicate size:
Small   Medium   Large   XL   XXL   I do not want a t-shirt
  Additional shirts may be purchased onsite for $10 while quantities last.
 
General Children (under 18 years) Guest Registration
Age(s) of children
   
Name(s) of children
Number of children x $20 $
Registration Fees Subtotal $
 
Special Sessions       Amount
Wednesday, May 10, 2017    
Morning - Use of Ultrasound in Obstetric Anesthesia Workshop, 8:00 a.m. – 12:00 p.m.
(limited to 36)
$295 $
Morning - Patient Safety Workshop: Leading Systems Change, 8:00 a.m. – 12:00 p.m.
(limited to 50)
$295 $
Afternoon - Focused Cardiac Ultrasound Workshop, 1:00 – 5:00 p.m. (limited to 24)
$295 $
Afternoon - Becoming a Successful Obstetric Anesthesiology Leader Workshop, 1:00 – 5:00 p.m. (limited to 50)
$295 $
Afternoon - Chinese Symposium on Obstetric Anesthesia, 1:00 – 5:00 p.m.
Complimentary $0
Special Sessions Subtotal $
 
Social Events    
Welcome Reception, Wednesday, May 10, 2017, 6:00 – 8:00 p.m.

*One ticket is included in the Full SOAP Conference Registration for attendees and one ticket
is included in the Guest Registration fee.
Additional tickets needed x $95 $
SOAP Annual Meeting Banquet, Friday, May 12, 2017, 6:00 p.m. - 10:00 p.m. Number of adults x $125

Number of children under 18 years x $60
$

$

Beer Tasting in Seattle, Saturday, May 13, 2017, 6:00 p.m. - 10:00 p.m.

(Tickets: $10 per attendee, includes ticket for one complimentary beer)

Number of attendees x $10
$
Social Events Subtotal $
 

Optional Fitness Event

5K Fun Run - Friday, May 12, 2017  
  $25 Donation to the Endowment Fund x number of people
$
 
 
Special Sessions, Social Events, Informal Social Event and Optional Fitness Event Subtotal $
 
Grand Total $

Cancellation Policy
Cancellations received in writing through April 26, 2017 will be refunded less a $100 administrative fee. No refunds will be made after April 26, 2017.

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