(e.g. MD, DO, CMD, GNP, PharmD, etc.)
Number where you can be reached regarding registration
All cancellations must be made in writing to MIMDA. Notices can be emailed to michiganmda@gmail.com. Cancellations received by October 4, 2021, will receive a full refund less a $50.00 administrative fee. Cancellations received between October 5-9, 2021, will be refunded half of the registration fee. Fees will be refunded the same way they were paid to MIMDA. Please allow up to four weeks for delivery of refund if payment was made by check. Cancellations received after October 9, 2021, will result in the forfeiture of all registration fees. No-Shows will also forfeit all registration fees. Partial or full fees that have been forfeited cannot be applied to subsequent meetings.
Please select which payment method you will use for your membership dues.
If attending in person, please choose a dinner.
If you are bringing a guest there will be an additional $30 charge. Please contact michiganmda@gmail.com with guest name and dinner selection.