Delegate Registration Form
STEP 1: Personal Details (Please print clearly. Enter single registrant or administrator of a group.)
☐ Prof. ☐ Dr. ☐ Mr. ☐ Mrs. ☐ Ms. (please check one)
First Name: Last Name:
Title: Company:
Address:
City: Prov/State:
Country: Postal Code/Zip:
Phone: Email:
Registration fee includes the Monday morning concurrent workshops, welcome coffee reception, afternoon coffee break, afternoon plenary session, reception, banquet and Tuesday breakfast, lunch, morning and afternoon coffee breaks and all day session.
STEP 2: Please indicate which workshop you plan to attend on Monday March 26, 2018. Space is limited. Please choose one only.
☐ Part 1: Stereotypes are a Thing of the Past – Spousal Succession is a Thing of the Future! – presented by Merle Good, GRS Consulting Ltd.; Part 2: Plan, Survive, Thrive – presented by Gail Schafer, Global Ag Risk Solutions
☐ Coaching 101: Tackling your Triggers!! – presented by Jacquie Stephens, Breakthrough Consulting
☐ Get on Board! – presented by Art Froehlich, AgriView Inc.
☐ Financial Workshop – presented by BMO Financial Group
☐ Difficult Conversations: What you need to know – presented by Genella Macintyre, Partners in Discovery Ltd.
STEP 3: Registration – Prices are quoted as per person
Registration Total Due
Full Registration: $729.75 ______
($695.00 plus GST)
Student Registration: $367.50 ______
($350.00 plus GST)
Producer Registration: $698.25 ______
($665.00 plus GST)
Government Registration: $695.00 ______
Group registration: $682.50 ------
Purchase 6 registrations at one time ($650.00 plus GST)
Administrator of group: (person who oversees registering the group, but is not part of the group.)
Name: ______
Email: ______Phone: ______
Registrants:
1. Name:______
Company: ______
Workshop selected: ______
Email:
2. Name:______
Company: ______
Workshop selected: ______
Email:
3. Name:______
Company: ______
Workshop selected: ______
Email:
4. Name: ______
Company: ______
Workshop selected: ______
Email:
5. Name: ______
Company: ______
Workshop selected: ______
Email:
6. Name: ______
Company: ______
Workshop selected: ______
Email:
Grand Total $ ______
NOTE: All payments must be made in Canadian funds. Registration will not be processed or acknowledgements sent until payment is received.
GST# 893865915
The conference will be recorded and photographed at the discretion of Iris Meck Communications Inc. Your registration and attendance at the event signifies your permission to utilize your image and/or likeness or words spoken or written about the Advancing Women Conference in printed and online reporting of the event in future promotions for perpetuity. No limitations or restrictions apply.
STEP 4: Method of Payment
Please choose one form of payment, tick “x” where applicable and complete the details below.
☐1. Pay by Cheque
Make cheque payable to “Iris Meck Communications Inc.” (with a memo of “Advancing Women”) in Canadian funds with all the correct information included and mailed with a copy of the registration form to: Advancing Women c/o Iris Meck Communications Inc., Suite 510, 5920 - 1 A Street SW, Calgary, Alberta, Canada T2H 0G3
☐2. Pay by Credit Card (please check one)
☐VISA ☐MasterCard
Credit Card Number: ______
Expiry Date: ______
Name as it appears on the front of the card: ______
CCV Code: ______
☐ I authorize the use of my credit card
(By agreeing, you authorize the use of your credit card. Your credit card statement will read “Iris Meck Communications Inc.”)
Cancellation Policy
No refunds will be processed; however, you can substitute attendees by contacting Iris Meck Communications Inc. by phone at: 403-686-8407, fax: 403-255-4592 or by email at:
Dietary Restrictions
Please advise of any food restrictions or dietary requirements that need to be met:
______
Registration Deadline
Registration will close on Thursday March 22, 2018 at 4:00 pm. Registration will resume on-site on Monday March 26, 2018. Check the agenda for times.
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