Online Registration Form

A. Identification

B. Perspective

Medical Speciality:
Professional License Number

C. Registration Fees

FULL SYMPOSIUM REGISTRATION

Before Jan. 31, 2020 After Jan. 31, 2020 After April 20, 2020 TOTAL $
Physician / Corporate Rep.
Genetic Counsellor / Nurse
$570 CAN $670 CAN $800 CAN
Post Doc. / Resident1
$540 CAN $645 CAN $760 CAN
Student2
$400 CAN $470 CAN $560 CAN

All fees are shown in Canadian funds. The Full Symposium registration fees includes access to sessions, continental breakfast each day, buffet lunch (May 6-7), coffee breaks and the Symposium documentation.

INDIVIDUAL DAY REGISTRATION

Before Jan. 31, 2020 After Jan. 31, 2020 After April 20, 2020                            
Physician / Corporate Rep.
$440 CAN $470 CAN $505 CAN  
Genetic Counsellor / Nurse
$330 CAN $360 CAN $390 CAN  
Post Doc. / Resident1
$320 CAN $360 CAN $390 CAN  
Student2
$240 CAN $260 CAN $280 CAN  
                                              
$   X    Days =  
Genetics and Genomics Glossary
An Introductory Session
Tuesday, 18:30 - 20:30
(already included in Full Symposium fees)
$55 CAN $60 CAN $65 CAN

1 Please provide proof of Post Doc / Resident status, i.e. letter from your programme director.

2 Please provide proof of full-time student status, i.e. copy of current student card or letter from your programme director.

Total Registration Fees


D. Special Interest Group (SIG) Preferences

Thursday, May 7, 2020

Please rank the SIGs in order of your preference (1-6). You will be assigned to two SIGs on a first come, first reserved basis.

Rarer moderate to highly penetrant breast and ovarian cancer syndromes - CDH1, PTEN, TP53, NTHL1 and others (SIG 1)

Genetic counselling – How to expect the unexpected? (SIG 2)

Hereditary prostate, pancreas and male breast cancer: Research updates and surveillance recommendations (SIG 3)

Moderate risk genes – When and where are they useful? (SIG 4)

Ethico-legal issues around usage of genomic data (SIG 5)

Ovarian cancer – a multi-faceted view (SIG 6)

E. Special Needs



F. Method of Payment

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

Cancellation Policy

Full refunds, less an administrative fee of $50.00, will be made for written cancellations received by February 16, 2020. After February 16, 2020, only 50% will be refunded, and no refunds will be issued for cancellations received after March 16, 2020.


 I have read and acknowledge the cancellation policy.