| IMPORTANT: Pre-registration required - Space is limited. Register today! |
 |
|
|
| Please choose one of the following options to register: |
|
|
|
| 1. Printer form (download, print, fill in and fax. Details on the form) |
|
|
|
| 2. On-line Form (Fill in all the following fields and click send - at the bottom - to register) |
|
|
|
 I. Registration Details |
|
|
|
|
|
|
| Surname |
|
|
| Name |
|
|
| Title |
|
|
| Organization |
|
|
| Address |
|
|
| City |
|
|
| Country |
|
|
| Postal Code |
|
|
| Phone |
|
|
| Fax |
|
|
| Email |
|
|
|
|
|
|
|
|
| II. Registration Fee |
|
|
|
|
|
|
| Regular |
|
CDN $400 |
| Student, retired, unemployed |
|
CDN $125 |
|
|
|
|
|
|
| III. Payment Options (see note below) |
|
|
|
|
|
|
| Payment in advance |
|
|
| On-site payment |
|
|
|
|
|
|
|
|
| IV. Attendance Confirmation |
|
|
|
|
|
|
We will seek to keep waste to a minimum for the duration of the event. Hence, we ask you to indicate below whether you will be
present during the whole conference, and be attending the various functions.
|
|
|
|
| I will be present: |
|
|
|
|
|
| a) on June 6th 2011 |
|
|
| b) on June 7th 2011 |
|
|
| c) on June 8th 2011 |
|
|
|
|
|
| d) at the cocktail on June 6th 2011 |
|
|
| e) at lunch on June 7th 2011 |
|
|
| f) at lunch on June 8th 2011 |
|
|
|
|
|
| Special dietary requirements |
|
|
|
|
| V. Additional information (optional) |
|
|
|
Message :
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
Payment Options
We will send you an invoice upon receipt of your registration form. Do not forget to specify in section 3 whether you will pay in advance or on site at the registration desk. IMPORTANT: No cancellation or refund after May 31st 2011.
A. Payment in advance
You can take advantage of one of two options:
1. You pay the amount yourself, either by cheque (Canadian currency only) or by credit card (Visa or MasterCard), in which case you
should send the invoice back to us immediately (along with your cheque or credit card details and signature).
2. Your organization pays the invoice upon receipt.
B. On-site payment
Pay cash, by cheque (Canadian currency only), debit (Interac) or credit card (Visa or MasterCard).
In either case, a receipt will be provided. |
