Alliance of Independent Academic Medical Centers

2016 Annual Meeting

Loews Ventana Canyon Resort

March 31 – April 2, 2016

Faculty Travel and Registration Form

Your Name:

TRAVEL Plans:

Hotel

The Alliance will make hotel reservations for you (in your name) at the Loews Ventana Canyon Resort. Up to two (2) nights’ guest room charges will be automatically billed to the AIAMC Master Account. You will be responsible for any incidental charges (e.g., room service, internet fees, etc.) you incur on-site; however, reasonable incidental expenses will be reimbursed.

Your confirmation number will be emailed to you. For more information on the hotel, visit www.loewshotels.com/Ventana

□ 1 person in room □ 2 persons in room □ Smoking Room

□ Other special requests:

I will be checking into the hotel on: □ March 30th or □ March 31st or □ April 1st

I will be checking out of the hotel on: □ March 31st or □ April 1st or □ April 2nd

Airfare and Ground Transportation

Please make your own transportation arrangements and keep your receipts for reimbursement. The AIAMC will reimburse coach airfare and reasonable ground transportation expenses.

Meals

Reasonable meal expenses incurred while traveling will be reimbursed by the AIAMC provided an expense form is completed and original receipts submitted. In an effort to control costs and enhance the meeting experience, we ask that faculty enjoy their meals on-site with other conference registrants as provided by the AIAMC.

Conference REGISTRATION:

Please note that online registration will open in mid November. All attendees, including faculty, must register online at www.aiamc.org. This ensures that we capture important information, including any special meal requirements as well as your name, title and contact information as you wish for it to appear in the meeting program.

As a faculty member, your registration fee will be waived. If, however, you wish to attend an event with a separate fee

(e.g., the Friday night awards dinner), you will be responsible for that event registration and pre-payment. Please note that special event seating is limited; thus, you are strongly encouraged to register online as early as possible.

Return via email or

fax 888-AIAMC11 (888-242-6211)

NO LATER THAN JANUARY 30, 2016