BRCA Public Conference Registration Form

A. Identification

Salutation:

First Name:*

Last Name:*

Address:*

City:*

Province/State:*

Country:*

Postal/ZIP Code:*

Telephone:*

Fax:

E-mail:*

Where did you hear about this Public Conference?

Please check here if you do not want your address to appear on the list of participants which may be distributed to participants.

B. Special Notes

C. Registration Fees



Before March 31, 2023	Before April 14, 2023		TOTAL $
$110 CAN	$130 CAN	Registration closes April 14

All fees are shown in Canadian funds. The Public Conference registration fees includes access to sessions, continental breakfast, buffet lunch, coffee breaks and the Conference documentation.

Total Registration Costs

D. Method of Payment

	Online Credit Card Payment (VISA, Mastercard, American Express, Diners Club, Discover, Carte Blanche or Visa Debit)
	Certified Cheque/Money Order/Bank Draft (Please make payable in Canadian funds to "O'Donoughue & Associates Event Management Re : BRCA2023")
	Credit Card Payment by Fax

Full refunds, less an administrative fee of $25.00, will be made for written cancellations received by March 31, 2023. No refunds will be issued for cancellations received after that date.

I have read and acknowledge the cancellation policy.

To complete your registration click:

To print this form for your records:

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BRCA Public Conference Registration Form

A. Identification

B. Special Notes

C. Registration Fees

FULL DAY REGISTRATION

Registration closes April 14

D. Method of Payment

Registration
closes
April 14