Companion Delegate Registration Form

Name:		Title:
Organization:
Mailing Address:

City:	Province:	Country:
Phone:	EMail:	Postal Code:
Fax:
Name to appear on Delegate Badge (if different from above)
Please explain any food allergies or special dietary needs :

CONVENTION REGISTRATION

Full Companion Delegate Registration: Participate in all available meals, evening events, and the hospitality suite.
			Total ($cdn)
	Member:	$385 (PAID before Sep. 1, 2011)
		$425 (after Sep. 1, 2011)
	Non-Member:	$465 (before Sep. 1, 2011)
		$505 (after Sep. 1, 2011)
Daily Companion Delegate Registration: Participate in all available meals, evening events, and the hospitality suite for selected day.
	Thursday, Nov. 17
	Member: $195	Non-Member: $250
	Friday, Nov. 18
	Member: $195	Non-Member: $250
	Saturday, Nov. 19
	Member: $195	Non-Member: $250
SUBTOTAL (A):

CANCELLATION & REFUNDS
• Refund (less 20%) if written cancellation is received before Sep. 1, 2011.
• Refund (less 50%) if written cancellation is received between Sep. 2 - Oct. 15, 2011.
• No refunds will be granted after Oct. 15, 2011.

(A) X 4% processing fee = (Fee1)
(A+Fee1) x 13% HST TAX (118829365TR0001) = (Tax1)

TOTAL = A + Fee1 + Tax1

Note: A 4% processing fee will be charged on all credit card transactions.