Register by November 1st to qualify for the Early-Bird Draw!
56th Annual Forest Pest Management Forum December 3 - 5, 2013 Ottawa Convention Centre 55 Colonel By Drive Ottawa, Ontario K1N 9J2 Canada
Registration contact: Mary Humphries 613-258-8241
REGISTRATION FORM DELEGATE INFORMATION City:
Name: Address:
Province/State: Postal/Zip Code:
Affiliation: Business phone:
Country:
Email:
REGISTRATION Options
*Students, get 50% lower price
Fee Payment
Check here if you are a student
1. Entire Forum (Tuesday, Wednesday and Thursday) $125.00 - until November 1, 2013 $175.00 - after November 1, 2013
2. Daily Session - Fill this section out if you plan on attending part of the Forum Daily Session Tuesday, December 3, 2013 - Main program
$60.00
Wednesday, December 4, 2013 - Main program
$60.00
Thursday, December 5, 2013 - CFIA led special feature
$60.00
*A student is defined as someone who is enrolled in a secondary or post-secondary institution or who has graduated within the past year.
Total Payment Due:
$
Special access needs
Pest Forum Poster Presenters (no cost to present when registered for the Forum) Title of scientific poster:
Author(s):
Submit an abstract of the poster via email, in Microsoft Word format to: ForestPestManagementForum@nrcan.gc.ca before November 1, 2013 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
Card number:
Mail: Forest Pest Management Forum c/o Eastern Ontario Model Forest P.O. Box 2111 Kemptville, Ontario K0G 1J0
VISA
MasterCard
Expiration date: Full name on card: Signature:
Receipts will be mailed out once registration payment has been received.