17th ANNUAL MIAMI CANCER MEETING (MCM)

Immunotherapy and Targeted Therapy in 2020: Moving Forward with Personalized Cancer Therapy

Edgardo S. Santos Castillero, MD, FACPFlorida Precision Oncology (FPO)

Medical OncologyClinical Associate Professor

Charles E. Schmidt College of MedicineFlorida Atlantic University

Aventura, FL

Luis E. Raez, MD, FACP, FCCPPresident, Florida Society of Clinical Oncology

(FLASCO)Chief Scientific Officer & Medical Director

Memorial Cancer InstituteClinical Professor of Medicine

Herbert Wertheim College of MedicineFlorida International University

Miami, FL

Accredited by:In Collaboration with:Oncology Latin

American AssociationFlorida Society of Clinical Oncology

PROGRAM DIRECTORS:

May 1-3, 2020Trump National Doral Miami

Miami, Florida

Sanjiv S. Agarwala, MDProfessor and ChiefHematology and OncologySt Luke’s Cancer CenterTemple University School of MedicineBethlehem, PA

Amanda Brahim, PharmD, BCOP, BCPS, BCACPPharmacy Clinical Manager, Hematology-Oncology-BMTResidency Program Director, PGY2 Oncology PharmacyMemorial Cancer InstitutePembroke Pines, FL

Mariana Chavez-McGregor, MD, MScAssociate Professor, TenuredDepartment of Health Services ResearchDivision of OVP, Cancer Prevention and Polulation SciencesThe University of Texas MD Anderson Cancer CenterHouston, TX

Gerardo Colón-Otero, MDProfessor of MedicineMayo Clinic College of MedicineDean, Mayo Clinic School of Medicine Florida CampusDivision of Hematology-OncologyMayo Clinic Cancer CenterNCI Designated Comprehensive Cancer CenterJacksonville, FL

Dina B. Dumercy McHenry, PharmD, BCOP, BCPSDirector of Pharmacy ServicesMiami Cancer Institute, Baptist Health South FloridaMiami, FL

Luis E. Fayad, MDProfessor in MedicineDepartment of Lymphoma and MyelomaDivision of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHouston, TX

Jorge J. Garcia, PharmD, MS, MHA, MBA, FACHEAssistant Vice PresidentSystem Oncology Pharmacy ServicesNon-Oncology Infusion Center Pharmacy ServicesCorporate Pharmacy Clinical EnterpriseMiami Cancer Institute, Baptist Health South Florida Member, Memorial Sloan Kettering Cancer AllianceMiami, FL

Sergio Giralt, MDMelvin Berlin Family Chair in Myeloma ResearchProfessor of Medicine Weill Cornell Medical CollegeChief Attending, Adult BMT ServiceMemorial Sloan Kettering Cancer CenterNew York, NY

Jhanelle E. Gray, MDCo-Leader, Chemical Biology and Molecular MedicineDirector, Thoracic Clinical ResearchEffective January 1, 2020 - Senior Moffit Medical GroupDepartment of Thoracic Oncology & Department of Tumor BiologyAssociate Professor Oncologic SciencesUniversity of South FloridaMorsani College of MedicineTampa, FL

D. Constanza Guaqueta, MDBreast Medical OncologistMemorial Cancer InstituteHollywood, FL

Robert Haddad, MDChief, Division of Head and Neck Oncology Institute Physician Dana Farber Cancer InstituteProfessor of MedicineHarvard Medical School Boston, MA

Michael Hurwitz, MD, PhDAssistant Professor of MedicineSection of Medical OncologyYale Comprehensive Cancer CenterNew Haven, CT

Atif M. Hussein, MDChief of Oncology/Hematology ServicesMemorial Cancer InstituteHollywood, FL

Christine L. Ibarra, PharmD, BCPSClinical Pharmacy Specialist, Thoracic ClinicMiami Cancer Institute, Baptist Health South FloridaMiami, FL

Jorge J. Garcia, PharmD, MS, MHA, MBA, FACHELuis E. Raez, MD, FACP, FCCPCaio Max S. Rocha-Lima, MD, MSRosanna Rodriguez, PA-C, MPH

Maray Salina, MSN, APRN, FNP-BCJose D. Sandoval-Sus, MD, FACPEdgardo S. Santos Castillero, MD, FACP

EDUCATIONAL COMMITTEE

DISTINGUISHED FACULTY

Educational Committee • Distinguished Faculty

Mohamed A. Kharfan-Dabaja, MD, MBA, FACPProfessor of MedicineVice-chair, HematologyDirector, Blood and Marrow Transplantation and Cellular TherapiesDirector, Inpatient Hematology ServiceMayo Clinic FloridaJacksonville, FL

Richard D. Kim, MDService Chief, GI OncologyAssociate StaffDepartment of Gastrointestinal OncologyH. Lee Moffitt Cancer CenterAssociate ProfessorUniversity of South FloridaTampa, FL

Ticiana A. Leal, MDAssistant Professor of MedicineThoracic Oncology Program DirectorDivision of Hematology, Medical Oncology and Palliative CareUniversity of Wisconsin School of Medicine and Public HealthMadison, WI

Ashwin Mehta, MD, MPHMedical Director of Integrative MedicineMedical Director of Physician WellnessMemorial Healthcare SystemHollywood, FL

Shanu Modi, MDMedical OncologistMemorial Sloan Kettering Cancer CenterNew York, NY

Alberto J. Montero, MD, MBA, CPHQStaff Physician, Cleveland ClinicMedical Breast OncologyTaussig Cancer InstituteCleveland, OH

Daniel Petrylak, MDDirector, Genitourinary Oncology Research ProgramCo-Director, Signal Transduction ProgramYale Comprehensive Cancer CenterYale School of MedicineNew Haven, CT

Javier Pinilla-Ibarz, MD, PhDSenior Member and Head, Lymphoma ServiceMoffitt Cancer CenterTampa, FL

Luis E. Raez, MD, FACP, FCCPPresident, Florida Society of Clinical Oncology (FLASCO)Chief Scientific Officer & Medical DirectorMemorial Cancer InstituteClinical Professor of MedicineHerbert Wertheim College of MedicineFlorida International UniversityMiami, FL

Caio Max S. Rocha-Lima, MD, MSM. Robert Cooper, Professor in Medical Oncology Co-Leader GI Oncology and Co-Leader Phase I ProgramDivision of Hematology and Oncology Wake Forest School of MedicineWinston-Salem, NC

Rosanna Rodriguez, PA-C, MPHInpatient Consult ServiceDivision of Solid Tumor and Benign HematologyMemorial Cancer Institute WestPembroke Pines, FL

Christian Rolfo, MD, PhD, MBA, Dr.h.c.Professor of MedicineDirector of Thoracic Medical Oncology ProgramDirector of Early Clinical TrialsExperimental Therapeutics Research ProgramMarlene and Stewart Greenebaum Comprehensive Cancer CenterUniversity of Maryland School of MedicineBaltimore, MD

Maray Salina, MSN, APRN, FNP-BCDirector of Oncology Support ServicesMemorial Healthcare ServicesHollywood, FL

Jose D. Sandoval-Sus, MD, FACPAssistant MemberDepartment of Malignant Hematology & Cellular TherapyMoffitt Cancer CenterMemorial Health Care SystemHollywood, FL

Edgardo S. Santos Castillero, MD, FACPFlorida Precision Oncology (FPO)Medical OncologyClinical Associate ProfessorCharles E. Schmidt College of MedicineFlorida Atlantic UniversityAventura, FL

Janakiraman Subramanian, MD, MPHAssociate Professor of MedicineDirector of Thoracic Oncology and Center for Precision OncologySaint Lukes Cancer InstituteUniversity of Missouri Kansas CityKansas City, MO

Michel Velez, MDDirector of Breast & GI Malignancies Medical Oncology DivisionMichael and Dianne Bienes Cancer CenterHoly Cross HospitalClinical Coordinator, University of Miami Residency ProgramHematology Oncology Division, HCHAssistant Professor, Clinical BiomedicineFlorida International UniversityFlorida Atlantic UniversityFort Lauderdale, FL

Educational Committee • Distinguished Faculty

CONFERENCE DESCRIPTION This 3-day conference is designed for medical oncologists, hematologists, radiation oncologists, surgical oncologists, physician assistants (PA), advanced registered nurse practitioners (ARNP), oncology nurses, registered pharmacists, pharmacy technicians, and radiation therapists. General practitioners (internal medicine and family medicine) will have the benefit of review standard of care and new developments in cancer management. Residents in training and fellows from these specialties are encouraged to attend.

Topics in solid tumors and hematological mal ignancies wi l l be reviewed and wil l include topics in breast cancer, lung cancer, gastrointestinal (GI) malignancies, gynecologic malignancies, genitourinary (GU) cancers, head and neck cancers, melanoma, and hematological malignancies such as multiple myeloma, CLL and non-Hodgkin’s lymphoma. There will also be a special session devoted to the area of palliative care, survivorship in oncology, targeted therapy and immunotherapy side effects management.

The areas of focus for this conference will include the current standards of care in the treatment of all aforementioned malignancies and new developments in these areas of cancer care. There will be much emphasis on molecular diagnosis and individualization of cancer therapy based on molecular profiles. There will be reviews of new chemotherapeutic, antiangiogenic and immunotherapeutic agents.

Presentations from the latest national (AACR, ASCO, SABC, and ASH) and international forums (ESMO and WCLC) meetings will be discussed and guidelines of cancer care using a team approach will be emphasized. The participants in the conference will have the opportunity not only to learn, review, and understand the state-of-the-art management in cancer care using a team approach but also engage in personal interaction with our panel of experts in these subjects during the question and answer sessions.

CONFERENCE OBJECTIVES Upon completion of this conference attendees will be able to:

1. Recognize the latest advances in chemotherapy, targeted therapy and immunotherapy options available for lung cancer, breast cancer, GI malignancies, GU malignancies, melanoma, head and neck cancer as well as hematological malignancies including multiple myeloma, NHL, AML, and CLL.

2. Evaluate the current standards of care in the treatment of a variety of solid and hematologic malignancies.

3. Discuss risks and benefits when combined modality of treatment (that includes radiation therapy and surgery) is being delivered to patients who have localized malignant processes (i.e., NSCLC, head and neck, prostate cancer, and others).

4. Formulate an individualized plan of care using a team approach to manage symptoms induced by chemotherapy, immunotherapy or targeted therapy such as auto immune complications, hematologic and metabolic toxicities.

ACCREDITATION AND CREDIT STATEMENTS

In support of improving patient care, the Medical Educator Consortium is jointly accredited by the Accreditation Council for C o n t i n u i n g M e d i c a l

Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician The Medical Educator Consortium designates this live activity for a maximum of 15.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

17th Annual Miami Cancer Meeting (MCM): Immunotherapy and Targeted Therapy in 2020:

Moving Forward with Personalized Cancer Therapy

17th Annual Miami Cancer Meeting (MCM): Immunotherapy and Targeted Therapy in 2020:

Moving Forward with Personalized Cancer Therapy

“Successful completion of this CME activity, which includes participation in

the evaluation component, enables the participant to earn up to 15.25 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certif ication (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.”

NursingThe Medical Educator Consortium designates this activity for 15.25 contact hours. Pharmacotherapy contact hours for Advance Practice Registered Nurses will be designated on your certificate.

PharmacistThis Application-based activity has been approved for 15.5 contact hours (1.25 CEUs) by the The Medical Educator Consortium. The Universal Activity Number for this program is

JA4008179-0000-20-014-L01-P. This learning activity is Application-based. Your CE credits wil l be electronically submitted to CPE Monitor® within 60 days upon successful completion of the activity.

Physician AssistantThe Medical Educator Consortium has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in

accordance with AAPA CME Criteria. This activity is designated for 15.25 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation.

Disclosure PolicyThe Medical Educator Consortium (MEC) adheres to the Joint Accreditation Criteria and ACCME Standards for Commercial Support, which requires everyone in a position of controlling the content of a CME/CE activity to disclose all relevant financial relationships with commercial interests related to the activity content. MEC has implemented a mechanism to identify and resolve all conflicts of interest prior to the CME/CE activity being delivered to learners. The source of all support from commercial interests will also be disclosed to learners prior to the beginning of the educational activity. CME/CE activities must be balanced, independent of commercial bias, and designed to improve quality in health care. All recommendations involving clinical medicine must be based on evidence within the medical profession.

Disclosure of Unlabeled UseThis educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contradictions, and warnings.

DisclaimerParticipants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contradictions and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

PROGRAM AGENDA

Day 1 | Friday, May 1, 2020

17TH ANNUAL MIAMI CANCER MEETING (MCM):

Immunotherapy and Targeted Therapy in 2020: Moving Forward with Personalized Cancer Therapy

May 1-3, 2020Trump National Doral Miami

Doral, Florida

12:00 pm – 7:30 pm Registration | Exhibits Open

12:30 pm – 2:30 pm Lunch & Learn Symposia (Non-CME/CE)

2:30 pm – 3:00 pm Visit Exhibits

3:00 pm – 3:10 pm WELCOME AND INTRODUCTION Luis E. Raez, MD, FACP, FCCP & Edgardo S. Santos Castillero, MD, FACP Program Co-Directors

3:10 pm – 6:00 pm Toxicity Profiles, Supportive Care and Challenges in Cancer Therapy Session Chairs: Dina B. Dumercy, PharmD BCOP, BCPS & Jorge J. Garcia, PharmD, MS, MBA, FACHE

New Agents and New Toxicities in Malignant Hematology: BCL2 Inhibitors and FLT3 Inhibitors Amanda Brahim, PharmD, BCOP, BCPS, BCACP

Management of Immunotherapy Related Adverse Events in Solid Tumors Christina L. Ibarra, PharmD, BCPS

Integrative Medicine in Cancer Care: What the patients should know Ashwin Mehta, MD, MPH

Biosimilars, Beyond the Scientific Review Jorge J. Garcia, PharmD, MS, MHA, MBA, FACHE

Cancer Survivorship: What are the Current Standards of Care in Solid Tumors Maray Salina, MSN, APRN, FNP-MC

Round Table Discussion | Q & A Session Panel: Brahim, Garcia, Ibarra, Mehta, Salina

6:00 pm – 6:20 pm Refreshment Break | Visit Exhibits

6:20 pm – 7:30 pm Head & Neck Cancers, Brain Tumors and Sarcoma Session Chair: Rossana Rodriguez, PA-C, MPH

New Approaches for Squamous Cell Carcinoma of Head and Neck and Thyroid Tumors Robert Haddad, MD

Systemic and Combined Therapy for Brain Malignancies and Soft Tissue Sarcomas Atif M. Hussein, MD

Round Table Discussion | Q & A Session Panel: Haddad, Hussein

7:30 pm – 9:00 pm Dinner & Learn Symposium (Non-CME/CE) (subject to availability)

3:10 pm – 3:40 pm

3:40 pm – 4:10 pm

4:10 pm – 4:40 pm

4:40 pm – 5:10 pm

5:10 pm – 5:40 pm

5:40 pm – 6:00 pm

6:20 pm – 6:50 pm

6:50 pm – 7:20 pm

7:20 pm – 7:30 pm

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Day 2 | Saturday, May 2, 2020

17th Annual Miami Cancer Meeting (MCM):

Immunotherapy and Targeted Therapy in 2020: Moving Forward with Personalized Cancer Therapy

7:00 am – 5:40 pm Registration | Exhibits Open

7:45 am – 9:00 am Immunotherapy Session Chair: Edgardo S. Santos Castillero, MD, FACP

Immunotherapy in Kidney & Bladder Tumors Michael Hurwitz, MD, PhD

Immunotherapy for Melanoma Sanjiv Agarwala, MD

Round Table Discussion | Q & A Session Panel: Agarwala and Hurwitz

9:00 am – 10:00 am Breakfast & Learn Symposium (Non-CME/CE)

10:00 am – 10:10 am Coffee | Visit Exhibits

10:10 am – 12:20 pm Lung Cancer Session Chair: Luis E. Raez, MD, FACP, FCCP

EGFR/ALK and ROS-1 Lung Cancer Management Edgardo S. Santos Castillero, MD, FACP

Uncommon Mutations: RET, MET, NTRK, & BRAF Janakiraman Subramanian, MD, MPH

Lung Cancer Neoadjuvant and Adjuvant Immunotherapy Luis E Raez, MD, FACP, FCCP

How to Choose Front Line Therapy for Metastatic NSCLC Jhanelle Gray, MD

Round Table Discussion | Q & A Session Panel: Gray, Raez, Santos, Subramanian

12:20 pm – 1:20 pm Lunch & Learn Symposium (Non-CME/CE)

1:20 pm – 1:40 pm Refreshment Break | Visit Exhibits

1:40 pm – 2:50 pm Genitourinary and Gynecologic Malignancies Session Chair: Rosanna Rodriguez, PA-C, MPH

Gynecologic Malignancies Gerardo Colon-Otero, MD

Prostate and Bladder Cancer Speaker: Daniel Petrylak, MD

Round Table Discussion | Q & A Session Panel: Colon-Otero, Petrylak

1:40 pm – 2:10 pm

2:10 pm – 2:40 pm

2:40 pm – 2:50 pm

10:10 am – 10:40 am

10:40 am – 11:10 am

11:10 am – 11:40 am

11:40 am – 12:10 pm

12:10 pm – 12:20 pm

7:45 am – 8:15 am

8:15 am – 8:45 am

8:45 am – 9:00 am

17th Annual Miami Cancer Meeting (MCM):

Immunotherapy and Targeted Therapy in 2020: Moving Forward with Personalized Cancer Therapy

2:50 pm – 3:50 pm International Society of Liquid Biopsies (ISLB) and MCM Symposia: Liquid Biopsies and New Biomarkers for Cancer Diagnosis and Therapy Chair: Luis E. Raez, MD, FACP, FCCP

Liquid Biopsies in Lung Cancer Christian Rolfo, MD, PhD, MBA, Dr.h.c.

Predictive and Prognostic: Value of TMB, MSI and PD-L1 in Liquid and Solid Tumor Specimens Ticiana A. Leal, MD

Round Table Discussion | Q & A Session Panel: Leal , Rolfo

3:50 pm – 4:10 pm Refreshment Break | Visit Exhibits

4:10 pm – 5:40 pm Gastrointestinal Malignancies Session Chair: Caio Rocha-Lima, MD

Gastric and Esophageal Cancer Updates Caio Rocha-Lima, MD

Metastatic Colorectal Cancer Therapy Richard D. Kim, MD

Round Table Discussion | Q & A Session Panel: Kim, Rocha-Lima

2:50 pm – 3:10 pm

3:10 pm – 3:40 pm

3:40 pm – 3:50 pm

4:10 pm – 4:40 pm

4:40 pm – 5:10 pm

5:10 pm – 5:40 pm

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17th Annual Miami Cancer Meeting (MCM):

Immunotherapy and Targeted Therapy in 2020: Moving Forward with Personalized Cancer Therapy

7:00 am – 8:00 am Registration | Visit Exhibits

8:00 am – 11:10 am Hematology Malignancies Session Chair: Jose Sandoval-Sus, MD, FACP

Chronic Lymphocytic and Myeloid Leukemias Javier Pinilla-Ibarz, MD, PhD

Hodgkin’s and Non-Hodgkin’s Lymphomas Luis E. Fayad, MD

Multiple Myeloma Sergio Giralt, MD

9:00 am – 10:00 am Breakfast & Learn Symposium (Non-CME/CE)

10:00 am – 10:20 am Coffee | Visit Exhibits

Bone Marrow Transplant and CAR T Cell Therapy in Hematology Malignancies Mohamed A. Kharfan-Dabaja, MD, MBA, FACP

Hematology Malignancies Case Presentations and Round Table Discussion Presenter: Jose Sandoval-Sus, MD, FACP Panel: Fayad, Giralt, Kharfan-Dabaja, Pinilla-Ibarz

11:10 am – 1:00 pm Breast Cancer Session Chair: D. Constanza Guaqueta, MD

Breast Cancer Immunotherapy Mariana Chavez-McGregor, MD, MSc

HER2-Driven Breast Cancer: Current Status and Next Generation Therapeutics Shanu Modi, MD

Hormonal Therapy in Breast Cancer Alberto Montero, MD, MBA, CPHQ

Parp Inhibitors and Chemotherapy for Breast Cancer D. Constanza Guaqueta, MD

Breast Cancer Case Presentations and Round Table Discussion Presenter: Michel Velez, MDPanel: Chavez-McGregor, Guaqueta, Modi, Montero, Velez

1:00 pm Closing Remarks and Meeting Adjourns

Day 3 | Sunday, May 3, 2020

11:10 am – 11:30 am

11:30 am – 11:50 am

11:50 am – 12:10 pm

12:10 pm 12:30 pm

12:30 pm 1:00 pm

8:00 am – 8:20 am

8:20 am – 8:40 am

8:40 am – 9:00 am

10:20 am – 10:40 am

10:40 am – 11:10 am

HOTEL INFORMATION

This iconic Miami hotel pairs legendary, championship golf courses with breathtaking views and elegant surroundings in a world-class destination infused with the standard of excellence, conveniently located 8 miles from Miami International Airport.

The prestigious 800-acre resort boasts four championship golf courses in Miami, among them the legendary Blue Monster, various recreational amenities, including brand new Har-Tru tennis courts, and a lively clubhouse, the hub of the resort. The Royal Palm Pool, with 18 private cabanas and a 125-foot slide, is the perfect setting for Miami weekend getaways, soaking in some sun, or poolside fun with your family.

The hotel is offering special rates during this conference of $239 run of house plus a $10 hotel service fee and tax. This rate is European plan (no meals). The cutoff date to make reservations is February 19, 2020, after this date reservations are subject to hotel availability.

Make your reservation today by calling 1-800-713-6725 or 305-592-2000 and identify yourself as attending the “Miami Cancer Meeting.”

Registration fee includes admission to the Friday, Saturday and Sunday scientific presentations and handout materials. Refunds must be provided in writing to info@meccinc.com on or before March 2, 2020. An administration fee applies to all refunds. No Refunds will be provided after March 2, 2020.

EARLY REGISTRATION IS RECOMMENDEDRegister online at www.meccinc.com

CONFERENCE MANAGEMENT

6619 S Dixie Highway #341, Miami, Florida 33143Telephone 305/663-1628 • Fax 305/675-2718 or visit our website at www.meccinc.com

Registration fee:Early bird pricing - BEFORE March 2, 2020 $225 Physicians $95 Residents/Fellows, Nurses, Nurse Practitioners, Physician Assistants,

Pharmacists & Other Health Professionals $300 Industry Professionals of Confirmed Exhibiting Company

AFTER March 2, 2020 $275 Physicians $115 Residents/Fellows, Nurses, Nurse Practitioners, Physician Assistants,

Pharmacists & Other Health Professionals $350 Industry Professionals of Confirmed Exhibiting Company $1000 Industry Professionals of Non-Exhibiting Company

Trump National Doral Miami4400 NW 87th AvenueDoral, FL 33178

REGISTRATION

REGISTRATION FORM

17th Annual Miami Cancer Meeting (MCM)Immunotherapy and Targeted Therapy in 2020:

Moving Forward with Personalized Cancer TherapyRegister online at www.meccinc.com or fax to 305/675-2718 (PRINT CLEARLY)

If you require special assistance or have specific dietary requirements, please contact MECC, Inc. by no later than March 2, 2020 via email at info@meccinc.com

Name_________________________________________________ Degree _________________

Address _______________________________________________________________________

City __________________________________________________________________________

State ____________________________________________ Zip __________________________

Telephone (_____)________________________________________ Fax (_____) _____________

Email address _____________________________________________ Specialty _____________

I authorize MECC to charge my credit card i/a/o $________ for registration of this conference using the following credit card.

Name on Card _____________________________________ Exp. Date _________________

Card number ______________________________________________ CVV ____________

Authorized signer ____________________________________________________________

License (Letters & Numbers): _________________________ State License Issued: ______________

PharmacistsNABP ePID: _________________________________________ Date of Birth (month/day) ______

Type of Practice: Private Academic Other

Hospital Resident/Fellow

REGISTRATION FEE: Early bird pricing - BEFORE March 2, 2020$225 Physicians$95 Residents/Fellows, Nurses, Nurse

Practitioners, Physician Assistants, Pharmacists & Other Health Professionals

$300 Industry Professionals - Confirmed Exhibiting Company

$1000 Industry Professionals - Not associated with an Exhibiting Company

AFTER March 2, 2020$275 Physicians$115 Residents/Fellows, Nurses, Nurse

Practitioners, Physician Assistants, Pharmacists & Other Health Professionals

$350 Industry Professionals - Confirmed Exhibiting Company

$1000 Industry Professionals - Not associated with an Exhibiting Company

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