Register by November 5th to qualify for the Early-Bird Draw!
2010 Forest Pest Management Forum November 30 - December 2, 2010
Château Cartier 1170 Chemin Aylmer Gatineau, Quebec J9H 7L3 Canada
DELEGATE INFORMATION
Registration contact: Mary Humphries 613-258-8241
REGISTRATION FORM
Name: City:
Address: Province/State:
Country:
Postal/Zip Code:
Affiliation:
Business phone:
Email:
Fax number:
REGISTRATION Options
Fee Payment
1. Entire Forum (Tuesday, Wednesday and Thursday) $200.00 - until Nov. 5, 2010 $250.00 - after Nov. 5, 2010
All sessions (including "Science and Technology à la carte" dinner) Please check box if you plan on attending the "Science and Technology à la carte" dinner
Yes
No
2. "Science and Technology à la carte" buffet dinner (Wednesday, 6:00 p.m.) Fill this section out if you plan on attending only this portion of the Forum.
$40.00
Sub-total:
$
Total payment due:
$
3. Special Feature Session only (Thursday)
Fill this section out if you plan on attending only this portion of the Forum. $60.00
All sessions, lunch and health breaks
Special needs (dietary or access):
Pest Forum Poster Presenters (no cost to present when registered for the Forum) Author(s):
Title of scientific poster:
Submit an abstract of the poster via email, in Microsoft Word format to: Sandy Knight (sandy.knight@NRCan-RNCan.gc.ca) before November 5, 2010 to ensure it is included in the Forum program. Payment options: Cheque (payable to Eastern Ontario Model Forest) or by credit card (by filling in section below)
Send by:
Credit card information:
Fax: 613-258-8363 Mail: Forest Pest Management Forum c/o Eastern Ontario Model Forest P.O. Box 2111 Kemptville, Ontario K0G 1J0
Card number: Expiration date: Full name on card: Signature:
Receipts will be mailed out once registration payment has been received.
VISA
MasterCard