Preliminary Program - National Medical Association

Transcription

Message from the President
3
Preliminary Schedule
4
Commercial Exhibits Info
7
Social Events Descriptions
8
Tickets Requests Form
10
Souvenir Booklet Ad Form
12
Camp NMA-zing
13
Housing Request Form
16
Sponsorship Levels
17
Golf
19
Travel Information
21
Dear Auxilians,
Welcome to the 2015-2016 year of the Auxiliary to the National Medical
Association.
I am honored to serve as the 77th president of the ANMA.
The Theme for the 2015-2016 year is Reducing Health Disparities through Heart Healthy Lifestyles. As we proceed through the program year, I am asking that our State and Local auxiliaries serve
the needs of our various communities by engaging in activities that highlight our service projects:
Healthy Heart, Triple Negative Breast Cancer, Prostate Cancer, and Childhood Obesity.
Our Convention Committee chaired by 74th President, Sharon Melvin, R.N., MPH, of Wilson North
Carolina, is hard at work to ensure that we have an exciting and successful convention in Los Angeles,
California, July 30 – August 3, 2016.
We will offer our signature fund raisers that support our scholarship programs: Golf, Local Tours and
opening of the Market Place on Saturday; Prayer Breakfast and Dinner Cruise on Sunday; and our
Scholarship Luncheon on Tuesday.
We will offer workshops under the direction of Health and Health Education Chair, Mrs. Gwendolyn
Taylor of Madison, Mississippi. Our workshops will highlight Heart Health, Breast Cancer, Prostate
Cancer and Childhood obesity.
I encourage all of our members and friends to join us in Los Angeles for an exciting and educational
convention.
Sincerely,
Morris L. Overstreet, Esq.
JW MARRIOTT Los Angeles L.A. Live
900 W Olympic Blvd
Los Angeles, CA 90015
Theme: “Reducing Health Disparities through Healthy Heart Lifestyles”
ANMA Convention Coordinators
Chair: Sharon C. Melvin, RN, MPH
Vice Chair: Ruth V. Creary, PhD
Hon. Morris L. Overstreet, President
Velva S. Clark, RN, BS, Chairperson, Board of Directors
FRIDAY, JULY 29, 2016
9:00 a.m. – 4:00 p.m.
Pre-Convention Board of Directors Meeting
Location: Plaza Rooms 1 & 2
SATURDAY, JULY 30, 2016
7:00 a.m. – 4:00 p.m.
Golf Outing – Angeles National Golf Club
7:00 a.m. – 8:30 a.m.
Walk a Mile with a Child
8:00 a.m. – 4:00 p.m.
ANMA General Registration
Location: Outside of Studio 3
8:30 a.m. – 4:00 p.m.
The Ultimate L.A. Tour
4:30 p.m. – 6:30 p.m.
ANMA Marketplace Formal Opening
Location: Foyer outside Platinum Ballroom (2nd fl)
4:30 p.m. – 9:00 p.m.
ANMA Marketplace
SUNDAY, JULY 31, 2016
7:00 a.m. – 9:00 a.m.
ANMA/NMA Prayer Breakfast & Memorial Service
Location: Platinum Ballroom, Salon D (2nd fl)
9:30 a.m. – 10:15 a.m.
ANMA Formal Opening
Location: Plaza Rooms 1, 2 & 3
10:00 a.m. – 4:00 p.m.
9:00 a.m. – 9:00 p.m.
ANMA Marketplace
10:30 a.m. – 11:30 a.m.
ANMA House of Delegates – First General Session
2:00 p.m. – 4:00 p.m.
Past President’s Council Meeting
4:45 p.m. – 10:45 p.m.
President’s Dinner Cruise
Location: Atrium 2
MONDAY, AUGUST 1, 2016
7:30 a.m. – 8:00 a.m.
ANMA House of Delegates Breakfast
8:00 a.m. – 4:00 p.m.
8:00 a.m. – 9:00 a.m.
ANMA House of Delegates – Second General Session
9:30 a.m. – 11:00 a.m.
Youth Health Forum/Project Sun / NAAYI
Location: Platinum Ballroom, Salon E (2nd fl)
9:00 a.m. – 9:00 p.m.
ANMA Marketplace
12:30 p.m. – 3:00 p.m.
Jazz Scholarship Luncheon
Location: Platinum Ballroom, Salon D (2nd fl)
TUESDAY, AUGUST 2, 2016
7:00 a.m. – 9:00 a.m.
Voting for 2016-17 ANMA Officers
8:00 a.m. – 9:00 a.m.
ANMA House of Delegates – Third General Session
Location: Atrium 3
9:00 a.m. – 9:00 p.m.
ANMA Marketplace
9:30 a.m. – 11: 30 a.m.
Prostate Cancer Workshop & Breakfast
12:30 p.m.—2:30 p.m.
Heart Disease Workshop & Lunch
WEDNESDAY, AUGUST 3, 2016
8:00 a.m. – 9:00 a.m.
ANMA House of Delegates – Fourth General Session
9:00 a.m. – 10:30 a.m.
Breast Cancer Workshop & Breakfast
9:00 a.m. – 2:00 p.m.
ANMA Marketplace
11:30 a.m. – 12:30 p.m.
Installation of the 78th President and 2016-17 Officers
12:30 p.m. – 3:00 p.m.
ANMA’s President’s Reception
3:00 p.m. – 5:00 p.m.
Post-Convention Board of Directors Meeting
Location: TBA
Location: Georgia Rooms 1 & 2
ANGELES NATIONAL GOLF CLUB
Saturday, July 30, 2016, 7:00 am—4:00 pm
Cost: $200 / $210
Tee time! Nestled at the base of the Angeles National
Forest and the only Nicklaus Design golf course in Los
Angeles County, Angeles National Golf Club sets the
standard of excellence and beauty for all golf courses
in Southern California.
Angeles National features an 18-hole, par 72-championship golf course with magnificent views,
generous fairways and immaculate emerald greens. The course presents a challenge for golfers
of all skill levels with four sets of tees accommodating both the professional and beginner
golfer. The course was ranked by Travel + Leisure Golf magazine as one of the Top 30 Best
New Courses Worldwide and One of the Top Ten Best New Public/Resort courses in the U.S.
Round-trip transportation provided from the J.W. Marriott Hotel. Includes green
fees, golf cart, bucket of balls, tournament services, breakfast and lunch.
THE ULTIMATE L.A. CITY TOUR
Saturday, July 30, 2016, 8:30 am—4:00 pm
Cost: $85 / $95
Welcome to Los Angeles! We have designed a full day
tour just for you to experience the best that LA has to
offer. See Santa Monica, Venice Beach, Downtown
Los Angeles, Hollywood, The Hollywood Sign, Griffith
Park, Hollywood Walk of Fame, Beverly Hills, Rodeo
Drive, Bel Air, Sunset Strip, Movie Stars’ Homes and more. You will not miss a thing on this
tour!!
Round-trip transportation provided from the J.W. Marriott Hotel. Lunch on your
own at the Farmer’s Market.
ANMA’s PRESIDENT’S DINNER CRUISE
Sunday, July 31, 2016, 4:45 pm—10:45 pm
Cost: $150 / $160 (cash bar)
Come aboard the “Entertainer,” we’re expecting you!
Posh in both amenities and appearance, the Entertainer
is right at home among the other multi-million dollar
yachts sailing southern California waters in the Marina Del Rey area.
You will enjoy an exclusive buffet dinner in her two spacious, fully enclosed decks, as you
cruise the Pacific Ocean. Then, dance the night away with familiar sounds that will bring back
cherished memories. When night falls, the open-air observation deck and aft deck are perfect
for a stroll and quiet conversations under the stars.
Round-trip transportation provided from the J.W. Marriott Hotel.
SCHOLARSHIP JAZZ LUNCHEON
Monday, August 1, 2016, 12:30 pm—3:00 pm
Cost: $120 / $130
Please join us and support our annual scholarship
luncheon where a portion of the proceeds provide
medical scholarships to third-year students attending
the four historically Black medical schools: Meharry, Charles Drew, Howard, and Morehouse.
Enjoy an afternoon of good food, finger popping and toe tapping jazz, and great conversations.
The event will feature one of our very own, Dr. Richard Allen Williams, President-elect of the
National Medical Association.
Come prepared to participate in our silent auction with beautiful artwork and more!
The ANMA “Marketplace” is one of the most exciting facets of our convention. Exhibits include Designer Apparel, Collages,
Custom Artwork, Lady’s Accessories, and much more.
ANMA is grateful for the continued patronage of exhibitors and supporters. During breaks, please visit the Marketplace
located in the PLATINUM BALLROOM FOYER in the JW MARRIOTT L.A. LIVE HOTEL.
EXHIBIT HOURS
Saturday, July 30
4:30 p.m. – 9:00 p.m.
Sunday, July 31
9:00 a.m. – 9:00 p.m.
If you are interested in exhibiting at the 2016 Annual Convention,
please contact the ANMA Office at 301-495-3779
or email at [email protected].
Booth Application is now available!
Monday, August 1
9:00 a.m. – 9:00 p.m.
Tuesday, August 2
9:00 a.m. – 9:00 p.m.
Wednesday, August 3
9:00 a.m. – 2:00 p.m.
Social Events & Complimentary Workshops
July 30—August 3, 2016
Price Prior to
June 30
Price After
June 30
Golf Package
Angeles National Golf Club
$200.00
$210.00
Saturday, July 30
8:30 a.m.—4:00 p.m.
The Ultimate L.A. City Tour, Hollywood,
Movie Stars’ Homes & Beaches
$85.00
$95.00
Saturday, July 30
4:30p.m. – 6:30p.m.
Market Place Ribbon Cutting
Welcome Reception
Wine Tasting/Entertainment
Complimentary
Saturday, July 30
NMA Formal Opening &
Awards Ceremony
See NMA
Program
Sunday, July 31
7:00a.m. – 9:00a.m.
ANMA/NMA Prayer Breakfast/Memorial
Service
$45.00
n/a
Sunday, July 31
4:45p.m. – 10:45p.m.
ANMA President’s Dinner Cruise
$150.00
Cash Bar
$160.00
Monday, August 1
9:30a.m. – 11:30 a.m.
Project Sun/NAAYI Health Forum
Complimentary
Monday, August 1
12:30p.m. – 3:00 p.m.
Scholarship Jazz Luncheon
$120.00
Tuesday, August 2
9:30a.m. – 11:30a.m.
Prostate Cancer Workshop & Breakfast
Complimentary
Tuesday, August 2
12:30p.m. – 2:30p.m.
Heart Disease Workshop & Lunch
Complimentary
Tuesday, August 2
NMA President’s Ball
See NMA
Program
Wednesday. August 3
9:00a.m. – 10:30 a.m.
Breast Cancer Workshop & Breakfast
Complimentary
Day/Date
Social Events
Saturday, July 30
7:00a.m. – 4:00p.m.
$130.00
TOTAL
# of
Tickets
Price
All ticket request for Social Events MUST be received NO LATER than June 15, 2016. Social Events NOT
meeting the minimal capacity (30) WILL BE CANCELLED in order to avoid ANMA penalties.
Tickets reserved prior to June 15, 2016 may be picked up at the ANMA Social Events Desk in the Registration Area.
PLEASE PRINT ALL INFORMATION IN INK AND LEGIBLY
Name
Email
Address
Home Phone (
City
)
State
Cell Phone (
Zip
)
Cash, Traveler's Checks, MasterCard, Visa and American Express are accepted at Convention.
NO PERSONAL CHECKS WILL BE ACCEPTED ON SITE!
If you are paying by:
 MasterCard  Visa or  American Express, please complete the following:
Account #:
Security Code:
Exp. Date:
Name as it appears on the card:
Signature:
Date:
Checks should be made payable to: ANMA, Inc.
Ticket request for Social Events should be mailed to:
ANMA, Inc.
8403 Colesville Road, Suite 820
Silver Spring, MD 20910
NO CHECKS “POSTMARKED” AFTER JUNE 15, 2016
For more information visit www.anmanet.org
***PRICES, TIMES AND EVENTS ARE SUBJECT TO CHANGE***
Auxiliary to the National Medical Association, Inc.
2016 Convention
SOUVENIR BOOKLET AD FORM
We are requesting your support of the ANMA, Inc. by purchasing an ad in our 2016 Convention souvenir program book.
You may place a congratulatory or promotional message about your business, organization or auxiliary.
Yes, I want to support the ANMA:
Full-page Ad
$350 ($300 if received by June 7, 2016)
Half-page Ad
$150
Quarter-page Ad
$75
Patron (name only listed)
$50
Name of Business/Family:
Contact Person/Title:
Telephone:
Fax:
Email:
Address:
City/State/Zip:
Type of Business:
Website:
Payment:
Check enclosed in the amount of $
Please charge my MC, AE or VISA $
Name as it appears on card:
Card Number:
Expiration Date:
Security Code
Billing address (if different)
Signature:
Make checks payable to ANMA, Inc. and mail it along with this form to:
ANMA, Inc.
8403 Colesville Road, Suite 820
Silver Spring, Maryland 20910
Ad submission deadline is June 7, 2016. Send camera ready ad in PDF or JPEG format along with this
form. Ads/forms may be emailed to the National Office at [email protected]
We agree to indemnify the publishers against any claim resulting from unauthorized use of any names, photographs,
sketches, artwork, registered trademarks, labels or words in our advertisement.
OFFICE USE ONLY:
Authorized Signature
Date Received:
__
DAILY SCHEDULE
The NMA has contracted Kamaàina Kids, Hawaiì’s Enrichment and Education Professionals, to conduct a fun-filled, enriching
program for youth of attendees of the NMA Convention and Scientific Assembly. The four-day Camp NMA-Zing program consists of
morning and evening sessions, with cultural and recreational activities. Our chaperone-to-youth ratios ensure that participants receive
safe, professional care. Program fees include: qualified chaperones certified in first aid and CPR; transportation; admissions; daily
lunches; four t-shirts; and insurance. Parents must pick up children at 4:00pm daily, provide dinner for child, and drop child off at
6:00pm for evening program. Program takes place at JW Marriott L.A. Live Hotel. Activities may be subject to change.
AGE
GROUPS
GROUP 1
3-5 YEARS
1:5
TIME
SUNDAY
July 31
MONDAY
August 1
MORNING
8:30am – 12pm
Natural History Museum
The Grammy Museum
LUNCH
12:00pm—1:00pm
Natural History Museum Cafe
Subway
AFTERNOON
1:00pm—4:00pm
EVENING
6pm – 9:30pm
GROUP 2
6-8 YEARS
1:6
GROUP 5&6
15+ YEARS
1:12
California Science Center
Knott’s Berry Farm
*8:30am—8:30pm
Includes lunch & dinner
Cafe
Bubble Mania Show and
Talent Show Practice
Astro Adventures & Camp
NMA-zing Talent Show
The Grammy Museum
LUNCH
12:00pm—1:00pm
Subway
Cafe
AFTERNOON
1:00pm—4:00pm
Ina Buckner
Kaleidoscope Show
Chazz Ross’ African
Drumming
Luce Puppet Show
*8:30am—8:30pm
Bubble Mania Show and
Talent Show Practice
Astro Adventures & Camp
MORNING
8:30am – 12pm
ANMA Project SUN
African American Museum
LUNCH
12:00pm—1:00pm
Subway
Café
AFTERNOON
1:00pm—4:00pm
EVENING
6pm – 9:30pm
GROUP 4
12-14
YEARS
1:10
Drumming
WEDNESDAY
August 3
MORNING
8:30am – 12pm
EVENING
6pm – 9:30pm
GROUP 3
9-11 YEARS
1:8
Ina Buckner
Kaleidoscope Show
Luce Puppet Show
TUESDAY
August 2
Drumming
The Grammy Museum
Michael McCarty’s African
American Stories
Ina Buckner
Kaleidoscope Show
Teresa Smith’s African Dance
MORNING
8:30am – 12pm
Hollywood Sightseeing Tour
ANMA Project SUN
LUNCH
12:00pm—1:00pm
Pig ‘n Whistle
Subway
AFTERNOON
1:00pm—4:00pm
Hollywood Walking Tour
The Grammy Museum
EVENING
6pm – 9:30pm
Skyspace
American Stories
MORNING
8:30am – 12pm
Hollywood Sightseeing Tour
ANMA Project SUN
Pig ‘n Whistle
Subway
Hollywood Walking Tour
The Grammy Museum
LUNCH
12:00pm—1:00pm
AFTERNOON
1:00pm—4:00pm
EVENING
6pm – 9:30pm
*8:30am—8:30pm
Astro Adventures &Camp
*8:30am—8:30pm
Cafe
Teen Dance
California Science
Center
*8:30am—8:30pm
Cafe
Skyspace
American Stories
Teen Dance
1.
The Natural History Museum of Los Angeles offers a collection from the natural world that’s sure to entertain kids and adults alike. It is
the oldest and largest natural history museum in the western United States, with more than 33 million items ranging from actual, full-size
dinosaur skeletons and meteorites from Mars to the live insect zoo and the largest collections of gold in the United States. Highlights include
the Dinosaur Hall, the Gem and Mineral Hall, the Insect Zoo, animal habitats from Africa and North America and the hands-on Discovery
Center.
2.
Astro Adventures, an outreach program presented by California Science Center educators, allows children to experience all the excitement
of being in space! Learn about the forces, temperatures, and pressures that astronauts have to overcome to get to and survive in space.
3.
Hollywood Sightseeing Tour takes us on a bus ride through Hollywood and Beverly Hills. We’ll see where stars live, shop and party; admire mansions of today’s hottest celebrities and legends; and stop for photo ops at renown locations like the Hollywood sign.
4.
The Hollywood Walking Tour takes us down the Hollywood Walk of Fame to various iconic spots like the Chinese Theatre, Egyptian
Theatre, Dolby Theatre, Jimmy Kimmel Live, Kodak Theatre, and more.
5.
The African American Museum exists to research, collect, preserve and interprets for public enrichment, the history, art and culture of
African Americans. The museum conserves more than 3,500 objects of art, historical artifacts and memorabilia and provides a variety of enriching, entertaining and enlightening learning experiences. The museum serves as a resource for diverse communities and to broaden public
awareness of the artistic, historical and cultural contributions of African Americans.
6.
Ina Buckner-Barnette, The Sunshine Storyteller, fills each show with an exciting and often humorous mix of participatory international
folktales, movement activities, songs, poetry and personal stories. Positive, character-building stories with an interactive twist are her trademark. Ina’s performances incorporate dance and song to help transport listeners on a magical story journey.
7.
OUE Skyspace LA is California’s tallest open-air observation deck and the premiere destination for panoramic, 360-degree views of Los
Angeles.
8.
The Grammy Museum pays tribute to music’s rich cultural history. This 21st century museum explores and celebrates the enduring legacies of all form of music, the creative process, the art and technology of the recording process and the history of the premier recognitions of
excellence in recorded music—the Grammy award. Through public and educational programs, exhibits and more, we will experience an insider perspective that only The Grammy Museum can deliver.
9.
Enter the fanciful world of Luce Puppet Company, which offers kids a chance to stretch their imaginations. Elizabeth Luce presents delightful hand and rod puppet shows performed on a colorful puppet stage with sound system, sets, curtains and lights. Luce brings to us The
Reluctant Dragon about a heroic boy, a dragon and a knight in a completely fake tournament of the century.
10. Project SUN is an annual event conducted by the Auxiliary to the National Medical Association (ANMA) for youth ages nine and up.
11. Aquarium of the Pacific offers Aquarium on Wheels, a mobile tide pool exhibit that allows guests the opportunity to feel a spiny sea star,
touch a slippery sea cucumber or experience the rough textured skin of a shark. Dedicated to developing an appreciation for the wonders of
the ocean environment, Aquarium on Wheels will deliver a memorable experience for all ages.
12. African Drum and Dance presented by CHAZZ and Teresa is a colorful and exhilarating experience into the world of African rhythms,
songs and stories. The audience will enjoy this lively presentation as either part of the drum circle or as part of the dance troop. Everyone will
feel the rhythm of the Serengeti sun as their simple drumbeats create a pulse that holds the music and dance together.
13. Michael McCarty is an internationally acclaimed storyteller who presents school assemblies on African and African-American stories, international folktales, historical tales, stories of science, spiritual stories as well as stories of the brilliant and absurd things he has done in his life.
His storytelling plays a valuable role in developing literacy, educating children about history and exploring multiculturalism.
14. Knott’s Berry Farm offers dozens of rides, shows and attractions. Experience world-class thrills on Silver Bullet, the park’s first-ever suspended coaster, or Sierra Sidewinder the spinning coaster that offers a panoramic view. Hop on board the Pony Express—The Ride, delivering
a horseback relay at speeds never imagined in the Old West. For something different, detour to the Park’s Old West Ghost Town or visit Camp
Snoopy, home of the Peanuts gang and filled with kid-sized adventures. The newest is a 4D ride Voyage to the Iron Reef, on which brave sea
navigators embark on a voyage that combines the fun of a theme park ride with the interactivity of high tech video games.
15. The California Science Center is a dynamic destination where families, adults and children can explore the wonders of science through
interactive exhibits, live demonstrations, innovative programs and awe-inspiring films. The facility includes four major exhibit areas – World
of Life; Creative World; Ecosystems; and Space Shuttle Endeavor, one of the most advanced transportation systems ever created. Exhibits
include over 100 hands-on science exhibits in immersive environments.
16. University of Southern California Campus Tour will introduce us to the beautiful University Park Campus and its significant points of
interest. The campus spans 226 acres just three miles south of Downtown Los Angeles, adjacent to the museums and recreational facilities of
historic Exposition Park. Rich with architectural history, the campus fosters a vibrant cultural community as well as a stimulating academic
environment.
17. Bubble Mania brings to us a show on the science and entertainment of bubbles with shimmering waves of soap films, rainbow bubbles, bubbles of all shapes and sizes, bouncing bubbles, and the grand finale where kids get the chance to be inside of a gigantic bubble! Bubblologists
will teach us about reflection, refraction, surface tension and many other soap bubble properties.
18. The Camp NMA-Zing Talent Show gives our young stars a chance to shine. Groups will practice a song, dance, skit or other talent to perform for our live audience of their peers and our staff judges!
19. The Camp NMA-Zing Teen Dance, for ages 12 and up, is an on-site dance party for youth to unwind, express imagination and artistry, and
celebrate with their friends. A live DJ, lighting effects, dance contests and more will make this last evening of camp one to remember.
2016 Camp NMA-Zing Registration Form
CONFERENCE ATTENDEE NAME:
CAMPER INFORMATION (PLEASE PRINT) FIRST, LAST, MIDDLE INITIAL
SEX
AGE
BIRTH DATE
T-SHIRT SIZE
(YOUTH OR
ADULT)
1.
2.
3.
NOTE: AVAILABLE T-SHIRT SIZES—YOUTH S, M, L; ADULT S, M, L, XL, XXL, XXXL
Program Information & Fees
Fees include transportation, admission, 4 lunches, 1 dinner, chaperones, and insurance. Early Bird registration is highly recommended (deadline: June 6, 2016). On-site registration will be
accepted on a space-available basis and t-shirts are not guaranteed. Cancellation before July 11, 2016 will incur a $50 fee. No refunds or cancellations after July 11, 2016.
1. Early Bird—Through June 6, 2016
2. Regular—June 7—August 3, 2016
3. Daily Registration (for on-site only)- July 31– Aug 3, 2016
⃝ $575/child X ________ = __________
⃝ $675/child X ________ = __________
⃝ $210/child X _________= __________
⃝ Sun
⃝ Mon
⃝ Tue—$260
⃝ Wed
Parent/Guardian/Sponsor Information (Children listed on this form will be released ONLY to the following adults)
FATHER/GUARDIAN
CELL PHONE
FATHER EMAIL ADDRESS
MOTHER/GUARDIAN
MOTHER EMAIL ADDRESS
EMERGENCY CONTACT
CELL PHONE
HOTEL NAME
ADDITIONAL AUTHORIZED PICK-UP
CELL PHONE
HOTEL ROOM #
CELL PHONE
Medical Conditions
Our child(ren) has/have the following medical conditions/allergies and/or language and/or special needs: (please attach additional paper if
necessary). Kamaàina Kids will contact you if necessary. Please note that youth who have fever will not be accepted in the program.
Allergies/ Food Preference:
___________________________________________________________________________________________________
Waiver & Release
I/We, the undersigned parent(s)/guardian(s), inconsideration of the contracted youth program services (“Kamaaina Kids”) providing child care for our child(ren)/ ward(s), named above, for the National Medical Association’s Convention (“the Association”) in Detroit MI, August 2-5, 2015,as designated below, do for myself/ourselves, my/our heirs, executors, administrators and assignees, hereby release and discharge demands, actions,
causes of action, or suits of any kind or nature whatsoever, which may arise from my/our child(ren)’s participation in the youth program, except for gross negligence or willful misconduct on the part of Kama’aina Kids
or the Association’s officers, directors, employees or agents. Furthermore, I/we agree to indemnify and to hold Kama’aina Kids & the Association harmless against loss from any and all claims, demands, damages,
actions, causes of action, or suits of any kind or nature whatsoever, that may hereafter be made or brought by my/our child(ren)/ ward(s) or by anyone on his/her/their behalf and I/we waive any and all rights of exemption
under any federal and/or state laws against all such claims. I/We give my child(ren)/ward(s) permission to attend and participate in the activities conducted by Kama’aina Kids during the NMA Convention. These activities may include, but are not limited to aquatics, off-property excursions, van/bus transportation, and enrichment activities. I/We authorize the Association & Kama’aina Kids to use my child’s name and video or photograph at any time and in any manner in connection with its advertising, publicity, and public relations program. The video/photo may only be used by Kama’aina Kids or Association. No further claims will be made by
me/us. Discipline is used to assure the safety and well-being of all program participants. All participants are expected to respect themselves, other people and their property. If a participant is not following the guidelines
of the NMA youth program staff consistent with these expectations, the parent(s)/guardian(s) will be notified that the participant may not be included in further programs. I/We hereby authorize the organization providing
child care and its employees to exercise these discipline policies in regard to my child. I/We understand that there will be no refunds for the youth program once payment is made.
I/We have read the above and understand this release. Furthermore, in the event of an emergency, the organization providing child care has my/our permission to administer first aid or obtain emergency medical treatment
in our child’s best interest. I/We agree to pay all expenses incurred due to an emergency involving our child.
Signature of Releaser:
Date:
Payment Information:
Payment Method: American Express
VISA
Master Card
Card Number:
Cardholder Name (Print):
Discover (payable to: National Medical Association)
Security Code:
Signature:
Fax to: 972-349-7715 or scan/email to [email protected]
Mail To: ATTN: Convention Registration Center, National Medical Association, PO Box 418146,Boston, MA 02241-8146
Exp. Date:
INSTRUCTIONS: Please complete all of the required information. Type or print legibly. If you are sharing a room,
please indicate in the space provided below. If you are booking two rooms, connecting rooms may be available.
NAME: _____________________________________________________________________
EMAIL: _____________________________________________________________________
ARRIVAL: __________________ DEPARTURE: ___________________ NO. OF ROOMS: __________
TYPE OF ACCOMMODATION
Please specify if two beds (double/double required and indicate name of “share with” person if
known. Rates include complimentary internet for attendees with Gold and Platinum Marriott
Rewards levels. Rates include tax of 15.5% plus a California tourism tax of $0.75.
Single and Double Room—$249 plus $39.35 = $288.35
Single

Double/Double 
King

Triple Room —$269 plus $42.35 = $311.45
Single

Double/Double 
King

Quad Room —$289 plus $45.55 = $334.55
Single

Double/Double 
King

SPECIAL REQUEST (e.g. low floor, near elevator, etc.):
__________________________________________________________________________
__________________________________________________________________________
All reservations require a credit card at the time the reservation is made. Confirmation of your hotel
room assignment will come from ANMA, Inc.
Hotel Reservation Payment Method:
Name as it appears on card: _____________________________________________________________
Card #: ________________________________________ Exp. __________________ CC: ________
Signature: _________________________________________________________________________
Please E-mail or Fax completed form to:
Email: [email protected]
Fax: (301) 495-0037
Convention Sponsorship and Advertisement Options




Name listed in the Convention Souvenir Booklet
Full Page Ad
Four (4) Dinner Cruise Tickets
Table of ten at the Scholarship Luncheon





Full Page Ad
Two (2) Dinner Cruise Tickets
Four (4) Scholarship Luncheon Tickets
You may choose to support one Alma Wells Givens medical scholarship recipient





Full Page Ad
One (1) Scholarship Luncheon Tickets
One (1) Dinner Cruise Tickets
You may choose to support one Omega Mason/Maude Bisson Nursing Scholarship recipient


Half Page Ad


Quarter Page Ad

JW Marriott Los Angeles L.A. Live
Los Angeles, CA
To confirm your support, please complete the information below and email to [email protected], or Fax to
(301) 495-0037, or mail with your payment to the address below. Questions should be directed to ANMA Office at (301) 4953779. (Please respond by June 15, 2016 to guarantee placement in Souvenir Journal.) Please Print Clearly
Contact Name: ____________________________________________________Title:_____________________________
Company/Organization: ______________________________________________________________________________
Address: _________________________________________________________ Suite/Floor________________________
City: _______________________________________________________ State: __________ Zip Code: ______________
Phone: _________________________ Fax: ___________________ Email: _____________________________________
Please list in printed materials as: ________________________________________________________________________
I agree to support the ANMA Events at the following level (Please check):
Sponsorship Opportunities:
Souvenir Journal:
 Platinum $5,000

Full Page $300 (before 6/7/16)
 Gold Sponsor $2,500

Full Page $350
 Silver Sponsor $1,000

Half Page $150
 Bronze Sponsor $500

Quarter Page $75
 Copper $250

Patron (name only listed) $50
 Supporter $100
Electronic, Camera Ready Advertisements are preferred
([email protected])
Tickets:

Dinner Cruise Table of 8 - $1,200

Individual Tickets—$150

Scholarship Luncheon Table of 10 - $1,200

Individual Tickets—$120
Please provide full payment when submitting this form. Any sponsorship not paid upon submission of this agreement will be invoiced for the
amount of the selected level of sponsorship.
Payment Method:
□ MasterCard
□ Visa
□ American Express
Payment by Check or Money Order:
□ Check
□ Money Order
(Please make payable to: ANMA, Inc.)
Cardholder's Name: ___________________________________________Card #:_________________________________
(as it appears on card)
Cardholder's Signature: _________________________________ Expiration Date: _____________ Security Code: __________
Mail this form to: ANMA Office, 8403 Colesville Road, Suite 820, Silver Spring, Maryland 20910
KEEP COPY FOR YOUR RECORDS
EVENT SCHEDULE
ANGELES NATIONAL GOLF CLUB
9401 Foothill Blvd
Sunland-Tijuana, CA 91040
Phone: (818) 951-8771
Cost:
$200 per player before June 15, 2016
$210 per player after June 15, 2016

6:30 a.m. –Buses depart from
JW Marriott Hotel

7:45 a.m.—Registration and
Breakfast

7:45 a.m. –Driving Range Opens

8:00 a.m. –Tournament Rules of
Play for Golf

8:15 a.m. Golf Tournament
Starts

Around noon - Awards
Ceremony & Luncheon

3:00 p.m. Departure for Hotel
ANMA’s Golf Tournament is a major fundraising activity to support scholarships to medical and nursing school students
and to support ANMA’s health education programs across the country.
For more information call (301) 495-3779 | Email: [email protected]
To confirm your support, please complete the information below and email to [email protected], or Fax to (301) 4950037, or mail with your payment to the address below. Questions should be directed to ANMA Office at (301) 495-3779. (Please
respond by June 7, 2016 to guarantee placement in Souvenir Journal)
Please Print Clearly
Contact Name: ______________________________________________________________Title:___________________________
Company/Organization: ______________________________________________________________________________________
Address: __________________________________________________________________ Suite/Floor_______________________
City: _____________________________________________________________________ State: _____ Zip Code: ____________
Phone: ____________________________________________ Cell#____________________________ Fax: ___________________
Email: ____________________________________________________________________________________________________
Please list in printed materials as: ______________________________________________________________________________
I agree to support the ANMA Golf Outing at the following level (Please check):
SIGNAGE OPPORTUNITIES:





Hole in One Sponsor …………………….…$2,000.00
2 Golfers
Signage with logo on Tee and Green
Recognition at Awards Ceremony
Half page in the ANMA Souvenir Program
 Hole Sponsors ………………………………..$250.00
 Signage with Company Logo on one of the 17 Tees
 Recognition in the ANMA Souvenir Program Booklet
 Individual Golfer ………….………………...$200.00
(Add $50 to be recognized as a hole sponsor)
To assure recognition in promotional materials, camera–ready
artwork, ad copy/or logo, must be received by June 7, 2016.

DONATIONS: I/We are unable to attend but would
like to make a donation in the amount of $______
TOTAL AMOUNT DUE: $_______________
Payment Method:
 MasterCard
 Visa
 AMEX
Check or Money Order Please make payable to ANMA, Inc.
 Check  Money Order
Mail to:
ANMA, Inc.
8403 Colesville Road, #820
Silver Spring, MD 20910
Cardholder's Name: ________________________________________Card #:_______________________________________
(As it appears on card)
Cardholder's Signature: ______________________________ Expiration Date: _____________ Security Code: _____________
GOLFERS
NAME:
Phone:
EMAIL:
NAME:
Phone:
EMAIL:
NAME:
Phone:
EMAIL:
NAME:
Phone:
EMAIL:
AIRLINE DISCOUNTS
The National Medical Association is pleased to offer discounted airfare programs on two carriers, Delta and United.
Delta is offering a discount from July 26 – August 7, 2016.
DELTA BOOKING CLASS - PERCENTAGE DISCOUNT
F / G / J / C / D / Y /A / P / I - 10%
B / M / S / H / Q / K / L - 5%
U / T / V / X - 2%
Use the following code: NMMZY.
Reservations and ticketing are available via www.delta.com/meetings. When booking online, select “Book Your Flight”
and enter the Meeting Code – NMMZY -- in the box provided.
You may also reserve tickets by calling Delta Meeting Network Reservations at 800-328-1111. Please note that a direct
ticketing charge will apply for booking by phone.
United is offering a discount from July 26-August 7, 2016.
UNITED BOOKING CLASS – PERCENTAGE DISCOUNT
F/J/Y – 10%
C/A/B/M/E/U/H – 5%
D/Z/P/Q/V/W/S/T/L/K/G/N – 2%
Use the following codes:
Agreement Code: 890635
Z Code: ZWCS
You may book online at www.united.com and provide the Agreement Code 890635 and Z Code ZWCS in the Offer
Code box when searching for your flights.
If booking through a travel professional or United Meetings at 800-426-1122, please provide the following information:
Agreement Code: 890635; Z Code: ZWCS. For all tickets issued through the United Meetings Reservations Desk,
there will be a booking service fee per ticket collected. This fee is subject to change without notice. It is non-refundable
and applies to all itineraries, one-way or round trip.
Los Angeles is served by a many other airlines, including American Jet Blue, and Southwest. However, NMA does not
have a discounted fare agreement these carriers.
GROUND/AIRPORT TRANSPORTATION
Los Angeles International Airport (LAX) is the main airport in Los Angeles, and it is located approximately 17 miles from
the LA Convention Center and downtown hotels, including NMA’s headquarters hotel, the J.W. Marriott Los Angeles at
L.A. Live. Travel time is 45 minutes to an hour, depending on traffic.
AIRPORT TRANSFERS
NMA is working with two shuttle services in Los Angeles who can provide transportation from Los Angeles Airport
(LAX) to your downtown hotel.
SuperShuttle
Super Shuttle operates 24 hours a day, seven days a week. It offers discounted rates to NMA attendees.


One way: $15.00 per person ($17.00 without discount)
Round trip: $30.00 per person ($32.00 without discount)
Please keep in mind that Super Shuttle does make a loop between the various terminals at the airport to pick up other
passengers. Visit SuperShuttle online at: http://www.supershuttle.com/default.aspx?GC=9STWK The discount code
for NMA is pre-entered. Or, call toll-free at 1-800-258-3826. Make sure to mention NMA 2016. Reservations are
highly recommended, although walk-ups are available. Cash and credit cards are accepted. Prices quoted are current
and are subject to change.
SuperShuttle also has car service available:
 Sedan: $68-74 + 18% gratuity (seats 3 passengers)
 SUV: $98-$104 + 20% gratuity (seats 5 passengers)
Karmel Shuttle
Karmel Shuttle operates 24 hours a day, seven days a week. It offers discounted rates to NMA attendees.


One way: $22.00 per person ($26.00 without discount)
Round trip: $44.00 per person ($52.00 without discount)
Karmel Shuttle does not stop and loop the airport to see if there are any additional passengers. There may be additional passengers if more than one person makes a reservation for the same time, but there are never more than three
stops within Los Angeles.
Reservations are required by clicking the link below
Discounted Airport Transfers for NMA Conference attendees...CLICK HERE!
Or, call the reservations department toll free at 1-888-995-7433. If calling to place a reservation, mention promo code
NMA16. “Ready-to-Go” program: If you note your cell phone number on your reservation request, you will receive a
text when your plane lands. It will advise to press the button on your screen when you have your luggage. Karmel will
dispatch the van immediately, including the van number, and also advise you where to stand.
Karmel has town cars ($115) and limousines ($150) available, which must be booked by phone.
Taxis
Taxis are located curbside on the Lower/Arrival Level in front of each terminal under the yellow sign indicating taxis.
Passengers will be given a ticket listing typical fares to major destinations.
The flat rate from LAX to the Los Angeles Convention Center is $46.50 plus a $4.00 airport surcharge. The flat rate
back to the airport from the Convention Center is $46.50
Uber and Lyft also operate out of LAX.

Preliminary Program - National Medical Association

Transcription

Similar documents

Pav Bhaji Malpua

After Party Flyer

I`m helping to end MS by participating in the 2016 Jayman BUILT MS

August 1-5, 2016 //Grandview Baptist Church, Kitchener, ON

The Board of Directors of Qatar Fuel (WOQOD) is pleased to invite

CAMP INVENTION REGISTRATION INFO

5 `S` Training Program at ABV-IIITM, Gwalior on 21.07.2016

pelligrosa press page 8

REANZ South - Reggio Emilia Aotearoa New Zealand

Porky Expo Flyer