2023 WSDA 89th Annual Meeting Registration

October 20-22, 2023
Suncadia Resort and Spa
Cle Elum, WA

Contact Information

Name*

First Last Credentials (MD, DO, PhD, etc.)

First Name for Badge (If Different than Above)

Group / Hospital Name*

Address*

Street Address Address Line 2 City State ZIP Code

Phone

Email*

Contact Information Sharing

By providing your consent, WSDA will only share your name and city with registered exhibitors. None of your other identifying contact information entered on this form will be shared.

Registration & Payment Information

Conference registration fee includes your three-day conference tuition, e-syllabus, opening night reception, as well as all breakfasts and refreshment breaks. The Saturday Night Dinner Banquet is free for the attendees. Guest are invited to dinner, please register your guest below.

Registrant*

General Registrant
Speaker
Board President

CONFERENCE REGISTRATION*

WSDA Member: - $500.00
Non-Member: - $675.00
Retired: - $350.00
Advanced Practice Clinicians: - $375.00
Resident-Member: No Charge - $0.00

I will be attending the dinner (included with registration)

Yes
No

No. of adult dinner guests:

Adult dinner guests are $75.00 each

No. of child dinner guests

Children ages 5-12 are $35 each; children under 5 years old are free.

Coupon

TOTAL

$0.00

Payment Type*

Credit Card
Check

Check Number*

CREDIT CARD*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

CANCELLATION POLICY: We must receive written notification of your cancellation. A $50 processing fee will be deducted from the registration refund. No refunds after September 5, 2023.

INQUIRIES:
Contact Delphi Locey, Association Executive, at the WSDA Office at (206) 956-3650 or send emails to washingtonderm.org.

Home of the Pacific Northwest Dermatological Conference

Home of the Pacific Northwest Dermatological Conference