ACCESS 2009 Registration form

Registration Fees

FEES: $30 regular registration; $15 student registration

Fees will be payable by cash or cheque at the Registration Desk during the conference. Please make cheques payable to ACCESS 2009.

Meals and nutrition breaks

Information TBA

 

 

     
   

ACCESS 2009 Registration form

FULL NAME & TITLE
  
     
AFFILIATION
  
     
ADDRESS 1
 
ADDRESS 2
 
CITY
  
PROVINCE
  
POSTAL CODE
 
     
TELEPHONE
  
fax
  
EMAIL
 
     
MEMBERSHIP
 
    ____________________________
I WILL BE ATTENDING:
    
check where applicable
  General Conference
  Special Session (Lobster)
    ____________________________
SPECIAL REQUESTS
   
Please list any special needs or dietary requirements
   
    ____________________________
I WOULD BE INTERESTED IN AN ACCESS 2009 T-SHIRT

(Checking 'yes' does not commit you, but it does enable us to gauge numbers.)
     
    YES     NO
    ____________________________
PLEASE CHECK ONE OF THE FOLLOWING
I am a:
   Student   
    Non-student