Welcome to OPGA: The Orthotic & Prosthetic Group of America

MAS Basic Observer & Advanced Course

Available October 24	Location: Chicago, IL Northwestern University Prosthetic & Orthotic Center
October 25	Chicago, IL Northwestern University Prosthetic & Orthotic Center

Credit card information must be received for registration to be processed.
Your credit card will not be billed until 45 days prior to the seminar.

Contact Information:

OPGA
P.O. Box 1467
Waterloo, IA 50704
Attn: Jim Andreassen

Cancellations must be received in writing
45 days prior to seminar to be refundable.
All cancellations are subject to a $25 handling fee.

***Minimum class size required***
OPGA reserves the right to cancel seminar due to lack of participation

Fax: 888-449-0610
Phone: 800-214-6742

Registration is limited

1. Complete the following registration information:

OPGA number:

Name:

Company:

Address:

City:

State:

Zip:

Phone number:

Fax number:

Email Address:

yourname@yourcompany.com

Which seminar would you prefer to attend?

October 24 - Basic Observer Course

October 25 - Advanced Course (must attend Basic Observer Course or Previous MAS Course)

2. Type of tier desired:

Basic Observer course only

Fee
$695 for OPGA and POINT members
$995 for non-OPGA and POINT members

Advanced course only

Fee
$695 for OPGA and POINT members
$995 for non-OPGA and POINT members

Both courses

Fee
$995 for OPGA and POINT members
$1,290 for non-OPGA and POINT members

All registration fees include the following:

Tuition fees for the full one or two-day seminar

Class room materials

Breakfast, lunch and afternoon breaks for attendees

3. For hotel reservations, complete the following:

Method of travel:

Flying

Driving

Arrival date

Departure date

Room Preferences:

Smoking

Non-smoking

Single

Double

Roommate

We will contact you with your confirmation number and room rate

4. Select payment method and enter total.

Your credit card will not be billed until 45 days prior to the seminar

Bill my Credit Card

Visa #

(ex. 1234567890123456)

Exp. date:

(ex. 01/00)

Master Card #

(ex. 1234567890123456)

Exp. date:

(ex. 01/00)

AMEX #

(ex. 1234567890123456)

Exp. date:

(ex. 01/00)

Name exactly as it appears on Credit Card

Authorization Code

Total Fee Charged

Pay By Check		Mail checks to: OPGA P.O. Box 1467 Waterloo, IA 50704 Attn: Jim Andreassen
	I understand that the check must be received to ensure a spot for the seminar.

OPGA: The Orthotic and Prosthetic Group of America
PO Box 1467 | Waterloo, IA 50704
800-214-6742 | Fax: 319-274-4468