2017 ACPEEC Registration Form (D0581490-3)

Alberta Chief Power Engineer Education ConferenceREGISTRATION FORM

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Alberta Chief Power Engineer Education ConferenceREGISTRATION FORM

CONFERENCE INFORMATION:

Chief Power Engineers or the Person in Charge are invited to attend andcan invite one person of their choosing to attend with them. Approved Power Engineering Training Providers are also invited to attend.

For more conference details please visit

General Information

Date:September 26, 2017

Time: Doors open at 7:30 am, conference runs from 8:30 am to 4:00 pm

Location: Delta Hotels by Marriott Edmonton South Conference Centre

4404 Gateway Blvd NW, Edmonton

Click here or call 1-800-661-1122 to book your room.

Conference Fee: $150.00 per person ($157.50 including GST)

Lunch is provided. (Please provide any special food requirements under participant info (page 2)).

Hospitality Suite:September 25, 2017, 7:00 pm – 10:00 pm

REGISTRATION INFORMATION:

Registration is subject to room size availability.

Please note: payment MUST accompany registration.

You are not registered in the conference unless payment is received prior to the conference.

Register by Fax or by Email

Payment by credit card or purchase order is required. Purchase order must accompany the application.
Complete page 2 of the registration form and fax to (780) 437-7787 or email to .

Register In-Person or by Mail

If payment is made by cheque, allow 10 business days in order to ensure adequate time for processing.
Complete registration form and mail together with payment to:

ABSA

9410 – 20th Avenue

Edmonton, AB T6N 0A4

Confirmation

You will receive email confirmation of registration. If you do not receive confirmation,
please phone (780) 433-0281 ext. 3385.

Cancellations and Substitutions

Payment is required in advance. If a written request for refund is made five (5) or more business days before the event, the registration fee, less a $20.00 administration charge, will be refunded.

Conferencefees include lunch and refreshments.

Please let us know in advance if you have any specific dietary needs.

PLEASE PRINT ALL REQUIRED INFORMATION IN BLOCK LETTERS AND SUBMIT THIS PAGE ONLY
PARTICIPANT INFO:
Name / Guest
Email Address / Email Address
Job Title / Tel # / ( )
Chief Power Engineer (or Person in Charge) / Job Title
Approved Training Provider / Food Requirements / Gluten Free Dairy Free
Company / Pork Free Vegetarian Other:
Mailing Address
City / Prov / Postal Code
Tel # / ( ) / Cell # / ( )
Can your name and company be provided to our sponsors? YES NO
Do you wish to receive emails about future Conferences? YES NO
Will you be attending the Hospitality Suite on September 25, 2017? YES NO MAYBE
Please indicate any special food requirements you may have:
Gluten Free Dairy Free Pork Free Vegetarian
Other: (Please indicate)
Please Note: payment MUST accompany registration
PAYMENT INFO: You are not registered in the class unless payment is received prior to the seminar.
Purchase Order / Purchase Order must be attached in order to process your application
/ / Cheque (made payable to ABSA) / GST Exemption No. (if applicable)
Card Number / Amount / $157.50 (1 Person) or $315.00 (2 People)
Expiry Date (mm/yy) / Name on Card
Signature:
Questions/Comments:
How did you hear about the conference?

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