2020 MMDA Annual Conference Attendee Registration | Mid-Atlantic Medical Directors Association

Join us at the MMDA 2020 Annual Virtual Meeting

Friday, November 13- Saturday, November 14

Registration Brochure

For individual and/or exhibitor registration information contact Lisa Williams at 410-625-0022 or mmdawebsite@gmail.com.

Please complete the registration form below. If you choose to pay via credit card, you will be directed to our secure online payment system using PayPal — you do not need a PayPal account to use PayPal. Registration payment will be available on your credit card statement.

For assistance, please send an e-mail to mmdawebsite@gmail.com or call 410-625-0022 to speak to MMDA staff.

First Name *

Last Name *

Degree *

Address *

Address 2

City *

State *

Zip *

Country *

Phone *

Fax

Fax where you can be reached regarding MMDA membership.

Email Address *

This address will not be shared without your permission.

LTC Facilities *

Please list the LTC facilities at which you work. Please include: street address, city, state and zip code. Put each facility on a separate line.

Join / Rejoin MMDA for 2021 and Save

Member (Physicians, APNs, PAs in practice) - 1-year membership - $125

Affiliate (Nurses, DONs, DDS, CNS, DPM, students of all disciplines, residents, fellows and other IDT members) - 1-year membership - $75

2020 MMDA Annual Virtual Conference Registration * *

Member - $225 (**you must become a member to choose this option.)

Non-Member - $250

Fellow - no fee

Resident - no fee

Student - no fee

Select from the following options:

Send Payment After you submit this membership dues form, you will be taken to a payment page where you can choose to pay your membership dues with a credit card using PayPal's secure onine system, or you may elect to send in your payment via fax or U.S. mail. Please be sure to click the submit button below.

Payment Method *

Online thru paypal

Check (Mail check/payable to” MMDA”, MMDA 1211 Cathedral Street, 3rd Floor, Baltimore, MD 21201-5516) Baltimore, MD 21201)

Fax credit card information to 410-385-0154

Please select an alternative payment method for your membership and/or registration fees if you are not paying thru Paypal.

Disclaimer

Handouts
If you have registered and have not received an email with instructions, please email mmdawebsite@gmail.com for instructions.