Greater Atlanta Professional Coders

Greater Atlanta Professional Coders

CPC Review Class Registration Form

Class Date: ________

Review classes are from 8:00 a.m. to 4:30 p.m.

To Register – Complete this registration form.

For additional information, contact: 2013 Education Officer, April Raines, MBA, CPC, CPAR

NAME OF REGISTRANT: _____________________________________________________

ADDRESS: _________________________________________________________________

PHONE: __________________________________________________

EMAIL: _____________________________________________________________________

EMPLOYER: _________________________________________________________________

FAX: __________________________________________________

NOTE: REGISTRATION FEE IS $50.00 PER PERSON.

Please mail completed registration form and payment to the Treasurer: Troy Thompson McCain, CPC, CPC-H

Greater Atlanta Professional Coders

c/o Troy Thompson McCain

P. O. Box 633

Tyrone, GA 30290

Make check/money order payable to: GAPC - Greater Atlanta Professional Coders

***If Less than 5 people register for this review, it will be canceled and all monies will be refunded.***

NO REFUNDS - IF YOU ARE UNABLE TO ATTEND, YOU MAY REQUEST A COPY OF THE HANDOUTS.

All Classes and exams are held at Emory University Hospital – 1364 Clifton Road – Atlanta, GA 30322

Classroom B&C (near the auditorium) (If a location change is necessary, you will be notified)

Directions and Parking Information: Use Rand McNally, Expedia, MapQuest or GPS

***PLEASE ALLOW AT LEAST 2 WEEKS FOR CEU CERTIFICATES***

(Unless other arrangements have been made.)