2021 Convention Registration First Name* Last Name* Title* (DNP, CRNA, SRNA, or other designations)Hospital / Employer / School* AANA #* Phone*Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Special Dietary Needs Registration FeesFull conference registration includes Friday, Saturday, Sunday plus Opening Reception, breaks, and Saturday Luncheon.Registration TypePlease choose one of the following that applies to you. AANA or TANA Member Non Member Retired CRNA Anesthesia Technicians or Registered Nurses PROMO Code Registration for Board Members* Full Conference Full Conference with ACLS/BLS/PALS ($200) ACLS/BLS/PALS Only ($200) Friday Only Saturday Only Sunday Only Friday & Saturday Saturday & Sunday Registration Discount for AANA or TANA Members* Full Conference ($230) Full Conference with ACLS/BLS/PALS ($288) Full Conference with ACLS/BLS Only ($268) Full Conference with BLS/PALS Only ($268) ACLS/BLS/PALS Only ($145) ACLS/BLS Only ($113) BLS/PALS Only ($113) Friday Only ($125) Saturday Only ($150) Sunday Only ($113) Friday & Saturday ($213) Saturday & Sunday ($200) Registration for AANA or TANA Members* Full Conference ($460) Full Conference with ACLS/BLS/PALS ($575) Full Conference with ACLS/BLS Only ($535) Full Conference with BLS/PALS Only ($535) ACLS/BLS/PALS Only ($290) ACLS/BLS Only ($225) BLS/PALS Only ($225) Friday Only ($250) Saturday Only ($300) Sunday Only ($225) Friday & Saturday ($425) Saturday & Sunday ($400) Registration for Non Members* Full Conference ($625) Full Conference with ACLS/BLS/PALS ($740) Full Conference with ACLS/BLS Only ($675) Full Conference with BLS/PALS Only ($675) ACLS/BLS/PALS Only ($425) ACLS/BLS Only ($325) BLS/PALS Only ($325) Friday Only ($375) Saturday Only ($400) Sunday Only ($375) Friday & Saturday ($650) Saturday & Sunday ($575) Registration for Retired CRNAs* Full Conference (does not include ACLS) Friday Only Saturday Only Sunday Only Friday & Saturday Saturday & Sunday Registration for Anesthesia Technicians* Full Conference ($85 - does not include ACLS/BLS/PALS) Special Events/Add OnsWould you like to register a guest?* Yes No Guest Name* First Last Guest is a Child Under 12 Years of Age* Yes ($15) No Guest Coffee Breaks* Yes ($50) No Guest Saturday Luncheon* Yes ($50) No Saturday Luncheon* Yes ($35) No Would you like to purchase CPC Core Modules?*Now you can purchase the newly revised and redesigned AANA CPC Core Modules Bundle for just $200. That’s a $20 savings off the current TANA price and $99 off the current AANA price as a benefit for convention registrants! Upon payment, TANA will email the seat codes to you to redeem at AANALearn.com and for access to the modules. Click here for more information! Please check the following if you would like to take advantage of this discount: Yes ($200) No Would you like to attend the TANA PAC Casino Night?*This is to support the TANA PAC and will take place on Saturday, October 16. Join us for an evening of games, silent auction, and a chance to win prizes! Indulge in Hors d’oeuvres and desserts. Cash bar. Tickets can be purchased in advance or onsite at the TANA PAC booth. Yes ($75) No TANA PAC Casino Night AttendeesPlease select the number of attendees, including guests.1234Help Sponsor a StudentAny amount is appreciated! This helps fund students to the AANA Mid Year Assembly. TANA PAC ContributionAny amount is appreciated! Total $0.00 Cancellation PolicyCancellations that occur: Before October 5 will receive a full refund Between October 5 and October 15 will receive a refund less a $50 cancellation fee On or after October 15 will not receive a refund, including no showsCredit Card Cardholder Name Card Details
