For Apm Office Only

APM 2017 Registration Refund Request Form

APM’s Refund Policy: Full refund, minus a $50 processing fee, if this form is received by APM no later than October 16, 2017. A 50% refund if this form is received by APM after October 16 and before, or on October 31, 2017. No refunds after October 31, 2017. Approved refunds are distributed approximately 30 days after conclusion of the Annual Meeting.

Once complete, fax to 301-656-0989 or e-mail scanned version to [email protected] with subject line ‘APM Annual Meeting Refund Request’

NAME: ADDRESS: CITY/STATE/ZIP: EMAIL PHONE: : EVENT TO BE REFUNDED: REASON FOR REFUND:

TOTAL REFUND AMOUNT REQUESTED: $

FOR APM OFFICE ONLY:

Refund approved? YES NO AMOUNT TO REFUND: $______

Approved by: ______Signed: ______