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Complete your vendor support and registration completely online!

Organization
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Attendees

Primary Contact


Second Attendee


Third Attendee


Fourth Attendee


Fifth Attendee

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Payment

Method of Payment: 
**If you are mailing a check, make the check payable to MN EMS Medical Directors and mail it to us at the address on the right.
**By checking the credit card box you authorize us to bill your credit card and agree to make payments according to your agreement with card issuer.

Confirmations/Cancellations Policies:

Please register for the conference as EARLY as possible.

Registrations will be confirmed via e-mail. Registrations received after August 25th WILL NOT be confirmed in writing.  

If canceled, the registration fee, minus a $50.00 processing charge, is refundable if notice of cancellation is received by August 22nd. 

No refunds will be made after August 22nd.

* Required

Minnesota EMS Medical Directors Association 
c/o Robin Hoppenrath

P.O. Box 1012 
Anoka, Minnesota 55304

763.222.6005

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