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TABLE OF CONTENTS

NEWSLETTER

FROM THE PEN OF THE PRESIDENT 2

An Interview with CEO Kevin Stump, Mississippi Organ Recovery Agency (MORA)

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2016 AMAT Conference

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Looking Back at the Transplant Games By: Kaylie Hoyle, Iowa Donor Network

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ECHO (Every Community Has Opportunity) Updates & Ideas for Action! July 10—July

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The Perfect Match .... with a Twist By Carla Hawkins , LifeLink of Georgia

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AMAT Member Spotlight: Karen Gans, Live On NY 13

National Minority Donor Awareness Week Set to Celebrate 20th Anniversary 14

Guide to AMAT 17

AMAT MEMBERSHIP FORM: Have you renewed your membership for 2016?

2016 AMAT Conference Registration Form

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AMAT Board of Directors

Remonia A. Chapman- President

Bobby Howard- Past President

Lisa Strother Upsher- Treasurer

Carla Hawkins- Secretary

Board Members

Brandi Ahonsi

Marion Schuck

Jackie Lue Raia

Freddy Medina

R. Scott Murphy

R. Kelvin Satcher

Misty Wilkie-Condiff

Noel Sanchez

FROM THE PEN OF THE PRESIDENT

Sensational summer greetings AMAT Members, Partners and Friends!

I hope that the summer months find you excited about the things that we have done and ready for the great things we have yet to do.

Let me first say: I am proud of and grateful for each of you. AMAT members and partners are committed to making a difference, and we are very much a part of the “Community of Practice,” wherein our partnerships save and enhance lives.

Community. What is Community? One of my favorite authors, Palmer Parkers, states that, “community is a place where the connections felt in our hearts make themselves known in the bonds between people, and where the tugging and pulling of those bonds keep opening our hearts.”

This is AMAT, a community of professionals who strive to achieve better results for the diverse populations we serve—despite the challenges we face. We can do this because we keep our hearts open to new possibilities. We are a community that embraces an EAGLE (Engaging, Achieving, Growing, Leading and Excelling) team vision, and as I have shared before, “Only VISION allows us to transform dreams of greatness into the reality of achievement through human action. VISION has no

boundaries and knows no limits.”

It’s with this spirit of vision and community collaboration that we embrace our partnership with Donate Life America and the ECHO (Every Community Has Opportunity) initiative. I’m so pleased that our AMAT workgroups are providing leadership, vision, and their voices. Voices that are being echoed around the country –all sharing the same message: Every community has the opportunity to register donors and benefit from life-saving transplants.

Our community extends even further as we join Dr. Clive Callender and the National Minority Organ Tissue Transplant Education Program (MOTTEP) to celebrate the 20th Anniversary of National Minority Donor Awareness Week, August 1 – 7. For 20 years, this observance has positively impacted our transplant community.

Finally, the Association of Organ Procurement Organizations (AOPO) community just celebrated its 33rd annual meeting, which focused on the theme “What If?” As I reflected on the theme, I could not help but wonder: “What if every OPO joined with AMAT in celebrating the gift of life through cultural empowerment? What if becoming an organizational member of AMAT or sending a staff member to the AMAT conference

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helped that partner organization achieve its goals? What if we all joined forces to address donation disparities in our multiethnic communities by sharing resources to strengthen our hospital development programs and community outreach?”

As we prepare to engage, empower, and enlighten our participants at our annual conference in September, I continue to focus on our EAGLE vision, and ask you to consider how your contribution to AMAT will allow us to soar to higher and higher heights.

Come to the conference in New Jersey. Be a part of AMAT’s mission and vision. Let’s strengthen our multicultural donation and transplant practices together.

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An Interview with CEO Kevin Stump, Mississippi Organ Recovery Agency (MORA)

Center for Organ Recovery & Education (CORE)

Tell us about yourself. How did you first become involved in donation and transplantation?

I graduated with a Bachelor’s degree in Biology in 1981 from Southern Nazarene University in Bethany, Oklahoma where I was born and raised. After a year of doing research at the University of Oklahoma Medical Center, I returned to school to graduate with a second Bachelor’s of Science in Nursing. My first job after graduating was working in a Pediatric Bone Marrow Transplant unit at the Children’s Hospital in Oklahoma City. After a year of working there the unit was shut down, and I worked in the PICU where I encountered both pediatric recipients and donors. After that, I went to work in the pediatric dialysis unit until we transplanted all of our patients. I then went to work at Saint Anthony’s Hospital in the Acute Dialysis Unit and took calls for the heart and kidney transplant programs. In 1988, I had the opportunity to join the recently formed independent Organ Procurement Agency in Oklahoma City, The Oklahoma Organ Sharing Network as an organ recovery coordinator.

How did you end up with MORA?

After two years at the Oklahoma Organ Sharing Network, I was given the opportunity by Mark Reiner to go work in Sacramento, California at the Golden State Donor Services. While there I had the honor to work with Amy Peele and begin to learn more about hospital development. After a year at Golden State Donor Services, I was offered and accepted the role of Director of Hospital Development. At the Annual AOPO meeting in Baltimore that year, I learned from the leadership of Organ Recovery Services in Dallas that the Mississippi Organ Procurement Organization was going through a transition and was looking for an individual to come in and organize the agency and increase organ donation. The ultimate goal of the OPO was to become independent. I was honored to be offered the job later that year and started in September of 1992 with myself and five other people.

How many people does MORA employ?

On July 1, 1994 the Mississippi Organ Recovery Agency solidified itself as an independent OPO. We have since grown from the original group of six employees to 54 full-time employees. In 2002, we

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Center for Organ Recovery & Education (CORE)

transitioned tissue donation from the Mississippi Lions Eye Bank to our organization. We continue to work very closely with the Mississippi Lions Eye Bank to facilitate corneal and ocular tissue donation.

What are MORA’s service area demographics?

The Mississippi Organ Recovery Agency covers a vast majority of the state of Mississippi (minus a few counties around the Memphis area). Our demographics are predominately Caucasian, 57 percent, and African American, 39 %. We also serve a population that’s two percent Hispanic, one percent Native American Indian, and one percent Asian. Over the last two years, MORA has seen our consent rate within our African American community slide downward from one of the highest consent rates in the country to one of the lowest. Much of this was due to issues that were going on in Mississippi, and around the country, and we have worked hard to reverse that trend. For March, April, and May of this year our hard work has begun to make an impact: Our conversion rate is more than 80 percent for each of those months.

How is the OPO performing? What are its goals for 2016?

Our goals for this year are a conversion rate of 80 percent and OTPD greater than 3.75. In addition, we have set a goal of more than 230 tissue donors for the year. So far, we are on track to exceed those goals for the year.

What is MORA doing to effectively increase conversion rates and donor FPA within the multicultural communities it serves?

In response to our decline in the African American community, we have re-established a Multi-Cultural Task Force within the agency. The mission of the Multi-Cultural Task Force is to educate and partner with community groups to dispel myths about organ, eye and tissue donation that may influence the group members’ end-of-life decisions to register as donors. In June, the committee released a survey to the public to receive feedback and gather concerns from those in the community. After examining the survey results, a community-wide outreach meeting was held with MORA employees and survey participants. The group discussed the survey results and MORA employees were able to provide straightforward answers to those in the community who had concerns and hesitations about donation. The meeting has already resulted in several new community and faith-based events geared toward educating the public about organ, eye and tissue donation. Those who attended the meeting have also agreed to help spread the importance of our mission by joining us as community liaisons.

The task force’s next educational initiative is presenting key facts about donation through the “Did You Know?” campaign. The campaign will focus on disseminating relevant donation statistics via local individuals who have been touched by the gift of donation. We believe our grassroots efforts and top-of-

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mind donation education, spurred by the “Did You Know” campaign, will help increase donor conversation rates.

What’s one thing many people might not know about MORA that they should know?

In August of 1994, shortly after we had gone independent, Jackie Lynch from what was then called Regional Organ Bank of Illinois (ROBI) called me and congratulated me on going independent. He then hit us up for some money to help support a new organization that had formed, the American Society of Minority Health and Transplant Professional, ASMHTP. From that point on, we’ve been an organizational member and encourage all of our employees to be individual members and become involved with the organization. In fact, MORA has even been the headquarters of AMAT (2001-2006) and has also had the benefit of two employees, Jeff Thomas and Kelvin Satcher, serve as past presidents. With the cultural ancestry and ethnicity in Mississippi, the decision to join ASMHTP was a very easy one. Over the years, because of our involvement with ASMHTP (now AMAT), I strongly believe we’ve seen a steady growth in donation rates within our multicultural communities. Our work with AMAT is also one of the reasons I feel we’ve been able to overcome recent donor declines brought on by events in our state. We are very much part of AMAT’s mission.

What’s next?

The future for MORA is looking good with our clinical organ and tissue recovery suites set to be finished in August of this year. In addition, we are beginning the process of taking the “Baldridge Journey.”

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2016 AMAT Conference

What’s emerging in the world of organ and tissue donation and transplantation?

What multicultural issues impact our efforts to save and heal more lives?

What keeps the key stakeholders awake at night?

Are you seeking fresh ideas for your outreach efforts and innovative ways to increase consent rates?

Then join us at AMAT’s 24th Annual Conference in New Jersey! Attendees will have the opportunity to hear from leaders within the field of organ and tissue donation and transplantation. . Confirmed speakers include: Dorry Lidor Segev, M.D., Ph.D., Johns Hopkins University, presenting on living kidney donation; Eduardo Rodriguez, M.D., D.D.S., of NYU Langone Medical Center, presenting on VCA; Sridhar Tayur, Ph.D., of Carnegie Mellon, presenting on innovative approaches to do-nor families, and so much more!

Hosted this year by NJ Sharing Network, in the Garden State, we will gather colleagues from around the country at the Hilton Short Hills, Short Hills, NJ, September 27-30.

Located a short 15 miles from Newark Liberty In-ternational Airport, The Hilton Short Hills offers fabulous shopping, spas, and sights. The Eforea Spa at Hilton Short Hills boasts a modern facility with 13 treatment rooms, a lap swimming pool, lounges, an extensive fitness center, and a full service salon. Stroll across the street to The Short Hills Mall for an indulgent shopping experience to rival any in NYC, which, by the way, is only a short 20 miles away. Don’t miss out, register online today! (Printable registration forms are also available within this PDF.)

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Looking Back at the Transplant Games

The Transplant Games: An Unforgettable Experience

By: Kaylie Hoyle, Iowa Donor Network

In mid-June, the Donate Life Transplant Games were held in Cleveland, Ohio. Organ transplant recipients, living donors, bone marrow, corneal and tissue transplant recipients — plus thousands of supporters — gathered at this multi-sport festival to celebrate, compete, and commemorate. In five days, 43 teams ranging from ages 4-87 participated in 21 events. The event signified much more than a competition, they were a true celebration of LIFE. To watch a myriad of survivors swim faster, jump higher, and throw further was simply inspiring. There was a high-level of athleticism on display at the Games but also a community of support and motivation for every sin-gle person competing. Each athlete had a story of strength and survival, and they stood at the games as beautiful tributes to their donors and donor families.

Through my experience with the Games and Team Iowa, I got to know the Windsor Family. Freddie, his wife Cindy, and two sons, Zion and Jayden. They traveled to Cleveland for their first experience competing in the Games. Freddie received a heart and kidney transplant in 2014 after two years of battling heart failure. He required assistance from a left ventricular assist de-vice and eventually a artificial heart before receiving his life-saving transplant. Cindy recounted their journey vividly and with emotion as her husband’s wait for a heart coincided with the pregnancy of their first child to-gether. “We were quite the mess,” she said.

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Looking Back at the Transplant Games

When speaking to Fred-die and Cindy about their Transplant Games experience, they both recalled, with fondness, the amazing memories made. Freddie stated that, “competing in the games gave me an op-portunity to prove to myself that I was ‘back to my old self.’ After be-ing so sick, this meant a lot to me. Competing, more importantly, meant that I had an op-portunity to really honor my donor, Steve.”

Cindy went on to add, “The overwhelming feeling of being in a room with thousands of organ recipients, living donors, donor families and supporters moved me. It made me step outside of our story and take a glimpse at the stories of others who have been on a frightening path of waiting for organ donation. It stirred up even more feelings of gratitude for Freddie's donor and donor family.”

And well, for three-year-old Zion, wearing Daddy’s first gold medals and riding the shuttle buses were just a few of his favorite highlights!

The Transplant Games were a testament to the courage and perseverance of the human spirit. Donor fami-lies, living donors or recipients, and other attendees were visibly honored to be part of the Games. Freddie’s son, Jayden, keenly noted the experience made him proud of his father.

And for my part, I was very proud to be among some of the most positive and life-cherishing people I have ever met.

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ECHO Updates & Ideas for Action!

Donate Life ECHO runs from July 10 through July 23. The national observance reminds us that every community has the ability to register donors and benefit from life-saving organ donation.

For more information on ECHO, including the video contest and resources your organization can use to participate, visit the AMAT website. —Ideas for Action— LifeChoice Donor Services is working on creating a Donate Life ECHO. We are sending out brand new tie dye shirts to all of our volunteers with a flyer about Donate Life ECHO and 10 ECHO cards with our local Donor Registry info on them. Our hope is that each volunteer will share the life-affirming message of the importance of donation within their communities … and create some great momentum for the Donate Life message across Connecticut and Massachusetts. We are also working with a videographer to share some powerful stories from the community during the observance, and we shared information about the observance with our hospitals. —Caitlyn Bernabucci, LifeChoice Donor Services For ECHO, Donor Network West will be creating and sharing a short video. We’ll be highlighting the "not-so-cool" or “inconvenient” things in life most people don’t feel like doing, but with a different take. We want to show these “inconvenient” activities/chores as things to celebrate when you have a second chance at life. For example, heart recipient Lisa Callaway doesn't mind parking far away because her transplant gave her a second chance, and her body can now handle the “inconvenient” distance. Lung recipient Isa Stenzel is excited to annoy her neighbors with her loud bag pipe practice because she has a new set of lungs. Dr. Maisha Gray-Diggs can see her co-workers rolling their eyes at her when she tells a bad joke because she has new corneas – so she tells lots of bad jokes! We’re taking the mundane and showing how people, especial transplant recipients, can view it as extraordinary! It really changes one’s perspective, and our call to action is: ECHO these stories, register as a donor, and don’t take life for granted. — Valerie Sepeda, Donor Network West “On the heels of DLA’s announcement of an expanded partnership with Walgreens, LifeLink of Georgia Education specialist Carla Hawkins created an ECHO Me ! Walgreens Community Day. It’s scheduled for July 16. Carla worked hard to secure the opportunity with the local store’s manager. We anticipate a diverse showing and great results from the event.” — LifeLink of Georgia Donate Life ECHO began on July 10 and will run through July 23. Thanks to all who participated in the ThunderClap that roared through social media on July 11! We had 481 supporters with a reach of 630, 630 people. It is not too late to get involved in this national observance focused on reaching multicultural communities. — Donate Life America

ECHO (Every Community Has Opportunity)

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ECHO (Every Community Has Opportunity)

Stephanie’s Story

By: Yie Foong, Live On NY

Stephanie was a beloved daughter and sister. Despite growing up in a family with a single mom who often wondered if she was providing enough for her children, Stephanie was always grateful for what she had and tried all she could to help those in need. A sophomore at Queensborough Community College in New York, she planned to study law so that she could fight for social justice and equality.

Stephanie was involved in a skiing accident on March 15, 2014. When her mother, Ming, and her older sister, Melissa, arrived at the hospital, they did not know what Stephanie’s prognosis was. All they could do was pray and hope.

On the third morning after the accident, Ming and Melissa were standing by Stephanie’s hospital bed when they both inexplicably began experiencing powerful feelings of peace and joy.

“As my mind kept on telling me that I should not feel this way,” says Ming, “I turned my head and looked at Melissa. She looked back, smiled and said, ‘Mama, I think we should be crying, but why do I feel happy?’”

Shortly after this moment, the doctor called Ming and Melissa into another room and said that there was nothing that could be done to save Stephanie. When the doctor then asked if they had ever considered organ donation, Melissa replied, “Stephanie would like that.”

“We went back to Stephanie’s room, and the feelings of peace and joy became stronger and stronger,” says Ming. “God must have come to welcome Stephanie home that morning.”

Stephanie’s donations saved the lives of five people. She was able to donate her heart, kidneys, liver and pancreas. When people who knew Stephanie heard about what had happened, many of them followed Stephanie’s example and registered their own decisions to be organ and tissue donors.

Says Ming, “We miss our Stephanie very much. Not one minute goes by that I don’t think about my daughter, but we are comforted in knowing that five families have been able to see their loved ones again because of Stephanie. It seemed at the time that we made the decision for Stephanie’s donation, but I know that Stephanie had made that decision herself long ago.”

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DDD= MEMBER SPOTLIGHT: Karen Gans

The Perfect Match … with a Twist By: Carla Hawkins, LifeLink of Georgia

During the summer, ice cream cones, vacations, and barbeques serve as great treats in the summer heat. However, on August 31, 2013, Kenneth Chavis received the best summer treat anyone could ask for: a life-saving kidney transplant at Piedmont Hospital in Atlanta, GA. A former Air Force serviceman and retired New Jersey Police Officer, Mr. Chavis, also known as Deacon Slim, was an active member of his church and community until finding out from his doctor that he was in stage four kidney failure. When his doctor told him he’d need dialysis, Ken responded that he answered to a higher authority and immediately began to pray. He believed a perfect match would come. Little did he know, his perfect match was his loving wife of 24 years, Dr. Sandra Chavis, also known as Sandy.

When she received the news about her husband’s illness, Dr. Sandy had no idea she could possibly be a match, a living kidney donor. She thought it’d be someone younger and healthier — in n Ken’s large family — that would be the match and save Ken’s life.

After all attempts to find a match had failed, Dr. Sandy prayed and came to the realization that she’d need to be tested. Many people doubted she’d be a suitable donor due to her age, and despite various challenges, a year after Deacon Slim’s diagnosis, Dr. Sandy was told she was, in fact, a perfect match for her husband. He would no longer need dialysis; his life would be saved.

Is there a better way to strengthen a bond of marriage than by literally giving of yourself to save your spouse?

Ken and Sandy Chavis are now volunteers with LifeLink of GA, and they look forward to every opportunity to share their amazing journey with others and encourage the public to give the gift of life through organ and tissue donation!

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DDD= MEMBER SPOTLIGHT: Karen Gans

Name: Karen Gans RN, CPTC Position: Senior Transplant Coordinator Organization: Live On NY

How long have you worked at Live on NY?

10 years this September! I cannot believe that it’s been 10 years I’m still working in the field as a clinical coordinator –and sometimes dreading (but usually loving) my 24 hour shifts. I’m not quite done being a Transplant Coordinator yet; I love donor management and knowing that I, along with a great team at Live On NY, work really hard to ensure that we are able to transplant as many organs as possible!

What’s your proudest work accomplishment? I have many proud moments, but my most memorable is when I served on the UNOS Region 9 Minority Affairs Committee. I was able to serve and represent minority and underserved communities. It was something I’d never before experienced.

If you were asked to share one important insight you’ve learned, with regard to lifesaving transplantation, what would it be? Working in organ and tissue donation is very bittersweet. How long have you been an AMAT member? Nine years! My first AMAT Conference was Chicago, 2007! Why is AMAT important to you and how have you contributed to AMAT’s mission? AMAT is important to me because I have grown with AMAT — just as I have watched AMAT grow. We have done so many important things and there is so much more to come, it’s an exciting time. When I first joined, I was just a watcher and listener, but, now I am the Chair of the API Committee. My goal is to teach others about our many API communities. What’s one thing people would be surprised to learn about you? I’m a Canadian—born and raised in the great city of Toronto!

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National Minority Donor Awareness Week: Au National Minority Donor Awareness Week #NMDAW20

August 1 — 8

National Minority Donor Awareness Week Set to Celebrate 20th Anniversary

A Statement from Dr. Clive Callender

In 2016, National MOTTEP is celebrating a significant milestone: the 20th anniversary of what began as Na-tional Minority Donor Awareness Day (NMDAD). National Minority Donor Awareness Week (NMDAW) is a special observance that aims to specifically educate minority communities on obstacles and concerns sur-rounding organ and tissue donation while also highlighting the many triumphs. When NMDAD was inaugurated in 1996, 46,000 people were on the national transplant waiting list. That number has now reached more than 121,000. The number one problem in transplantation remains the shortage of organs. Minorities wait twice as long for transplant. Minorities continue to have a disproportionately higher incidence of diabetes, high blood pressure, and heart disease — all of which lead to organ failure, especially kidney failure. This is why the journey of saving lives must continue. 22 people die daily awaiting a transplant due to the donor shortage, therefore, National Minority Donor Awareness Week is yet another vehicle to promote the positive messages that will enable the minority community to make informed decisions about registering as organ and tissue donors. The overall goal is to increase the number of minority organ donors which will help meet an ever increasing demand. The continuous support and hard work of our nation’s OPO’S and other organizations has been critical. Minority donation rates have doubled from 15% to 31%. Our goal for 2016 is 35%. Working together, this goal can be accomplished. We would like all ethnic groups to: Register to become an organ/tissue donors; Have a family discussion and share wishes to become organ /tissue donor in life or after death and ... Open doors to churches, social circles, and/or community groups so that we can all discuss how to live

healthier lives and how we can help others through the donation of organs and/or tissues in life and af-ter death.

Clive Callender, M.D., FACS Founder, National MOTTEP

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MAT ENVISIONS a nation where transplant organizations apply a multicultural perspective to their relationships with donor families, transplant patients, healthcare professionals, and the general public. We aspire to be a part of a nation where people of all cultures embrace organ, eye and tissue donation as a social responsibility.

PROFESSIONAL DEVELOPMENT equips AMAT members with the tools to take your careers to the next level. As a member of AMAT, you have the opportunity to enhance your scope of practice and knowledge of current industry standards, access thought-provoking webinars, and attend yearly conferences. In addition to earning continuing education units (CEUs) through ongoing webinars and sessions held at the annual meeting, AMAT members have the unique opportunity to network with veteran multicultural transplantation and organ procurement organization (OPO) professionals who welcome the chance to share their expertise and advice for successfully mapping out long and fruitful careers in this lifesaving industry. SHARED BEST PRACTICES allow AMAT members to exchange ideas, insights, and guidance on the outcomes-driven best practices that have proven to be effective when reaching multicultural communities with the lifesaving message of organ, eye, and tissue donation and transplantation. AMAT members have access to free webinars that feature industry thought leaders, clinicians, researchers, as well as individuals who have direct connections to organ, eye, and tissue donation as transplant recipients and donor family members. AMAT members also receive member-only digital communiqués and newsletters that explore emerging and innovative best practices designed to better equip readers with the tools and resources for continued success and professional development. MULTICULTURAL WORKGROUPS offer advocacy, cultural insight, and nuanced approaches to ensure that all ethnically diverse communities are represented in the tapestry of organ, eye, and tissue donation and transplantation in the U.S. Boasting four multicultural workgroups—the Asian/Pacific Islander Workgroup, the African American Workgroup, the Latino Workgroup and the newly-launched American Indian Workgroup—AMAT members are uniquely positioned for enhanced cultural competency and cross-pollination of ideas and strategies designed to strategically engage with ethnically diverse communities and stakeholders. MEMBERSHIP IN AMAT is an annual commitment, which is renewable each calendar year. Our goal is to increase our membership base and annual conference participation with OPO professionals from various fields and cultural communities. This will help to enhance the exchange of ideas and best practices shared at the yearly meeting. WHETHER YOU ARE JOINING AMAT for the first time, or renewing your annual membership, we urge you to invite one or two of your colleagues to consider membership in AMAT. In addition, we hope that your organization will take advantage of the Organizational Membership, which provides a greater level of national support for AMAT; it also entitles AMAT members from your organization to receive discounts on individual memberships and our amazing annual conference. Your company will also be featured on both our website and Facebook pages. YOU CAN SIGN UP ONLINE, yes online! Please visit our website www.AMAT1.org to renew your membership - it’s fast and easy! You can also complete membership form (next page), include your check and mail everything in.

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GUIDE TO AMAT

24th Annual Conference

Tuesday, September 27, 2016 – Friday, September 30, 2016

Hilton Short Hills

41 John F. Kennedy Parkway, Short Hills, New Jersey, 07078

HOTEL RESERVATIONS - AMAT has reserved a block of rooms at the luxurious Hilton Short Hills, a AAA

Four Diamond-rated hotel located steps from the upscale Mall at Short Hills in New Jersey, offering a

prime location.

Please make your reservation online: https://aws.passkey.com/event/15478497/owner/17466/home

AIRLINE RESERVATIONS - Several major airlines serve Newark Liberty International (EWR) making your

travel to the hotel convenient and accessible (13 miles).

REGISTRATION FEES

Early (Reduced) Registration Registration after September 1

AMAT Members - $650 AMAT Members $700 Organization Member- $600 Organization Member $650 Non- Members-$700 Non- Members $750 Single Day Registration is $300/day Transplant Recipient and or Donor Family $100/day

CANCELLATION POLICY: Must be received before September 1 and submitted in writing. AMAT refunds

a $100 processing fee. There will not be a refund for cancellations submitted after September 1. If you

cannot attend the conference, please send a representative in your stead.

Questions? Contact Jackie Lue Raia, Assistant Director, Resource Development, NJ Sharing Network Email: JLueRaia@njsharingnetwork.org Phone: 862.216.7187

24th Annual Conference

Hilton Short Hills, Short Hills, NJ

Conference Registration Form

Name/Credentials: _____________________________________________________________ Position: ___________________________________________ Department________________ Institution: ___________________________________________________________________ Street Address: ________________________________________________________________ City _____________________________________ State/Province ________________________ Zip/Postal Code: _______________________________ Country _________________________ Email _________________________________________________________________________ Telephone ______________ Cell (Option) _______________ Fax _________________________ Emergency Contact Name________________________ Relationship________________ Phone/Cell _____________

“Celebration of Culture” Gala at Liberty Science Center

You are invited and encouraged to wear clothing that represents your heritage and culture.

Thursday, September 29, 2016

6:00PM - 9:00PM

Shuttle pick-up at Hilton Lobby: 5:30PM

This event is being hosted by NJ Sharing Network, and includes transportation, food, and drink.

All conference attendees are invited to attend, and there is no additional fee, but due to limited space

pre-registration is required.

Will you attend?

Yes

No

Conference Payment Information:

VISA ______ MC______ Exp Date______

Check Payable to AMAT___________

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Signature ________________________________________________________________________

Make checks payable to: Association For Multicultural Affairs in Transplantation

Mail registration and payment to: Association for Multicultural Affairs in Transplantation 10825 Midlothian Turnpike, Suite 201R Richmond, VA 23235

New Renewal FriendDate:_________________ Active Individual ($150) Friend ($75) (*only $135 with Organizational Membership) Name:______________________________________ T-Shirt Size_____________________

Organization Name:__________________________________________________________

Title:______________________________________________________________________

Address:___________________________________________________________________

City:________________________________ State:________ Zip:_____________________

Phone: __________________________________ Email:_____________________________

EMPLOYER:Community Hospital University Medical Center Private Foundation Blood BankPhysician’s Office Military/VA Hospital Tissue Bank Eye BankHospital Based OPO Independant OPO Pharmaceutical Other:__________

Make check or money order payable to AMAT and send with membership form to: AMAT Membership,10825 Midlothian Turnpike, Suite 201R Richmond, VA 23235

Membership Application Form

For Office Use:Date:_________Check Number:____Personal/Employer CheckOther________

Check/Credit Card:

Visa MasterCard AMEX Discover

CC #:____________________________Exp: ____________________ Security Code:________________________

Individual Members Recieve:• Professional Growth• Access to Resources• Educational Enhancement• Networking• Knowledge of Current Industry Standards

Annual membership expires on December 31st of each calendar year - remember to renew!

Toll free: 1-844-654-AMAT (2628) Fax: 804-723-0416Email: info@amat1.org website: www.amat1.org

Organizational MembershipDate:_________________ Organizational Member ($1500) *Email logo to: info@amat1.org (*unlimited individual memberships at a discount rate of $135 per person)

Name:_____________________________________________________________________

Organization Name:__________________________________________________________

Title:______________________________________________________________________

Address:___________________________________________________________________

City:________________________________ State:________ Zip:_____________________

Phone: __________________________________ Email:_____________________________

Website:_________________________________ Number of Staff:____________________

Remit a check or money order payable to AMAT and attach with this membership form. Submit payment/form to: AMAT Membership: 10825 Midlothian Turnpike Suite 201R Richmond, VA 23235

Membership Application FormAnnual membership expires on December 31st of each

calendar year - remember to renew!

For Office Use:Date:_________Check Number:____Personal/Employer CheckOther________

Community Hospital University Medical Center Private Foundation Blood BankPhysician’s Office Military/VA Hospital Tissue Bank Eye BankHospital Based OPO Independant OPO Pharmaceutical Other:__________

Toll free: 1-844-654-AMAT (2628) Fax: 804-723-0416 Email: info@amat1.org website: www.amat1.org

Check/Credit Card:

Visa MasterCard AMEX Discover

CC #:____________________________

ORGANIZATIONAL MEMBERS RECEIVE:• Unlimited individual memberships for staff at 10% discounted rate (only $135 per person)• Recognition on the AMAT website as an Organizational Member• 15% discount to the Annual AMAT conference for each Individual Member who has joined as part of your

Organizational Membership• The statisfaction of supporting multicultural leadership in the transplant community and making a difference

nationally with regards to diversity matters facing the transplant industry

Contact information for those who may be interested in joining AMAT (we’ll provide additional information)______________________________________________________________________________________

______________________________________________________________________________________

ORGANIZATION: