Online Registration Form

A. Identification

B. Perspective

Medical Speciality:
Professional License Number

C. Registration Fees

FULL SYMPOSIUM REGISTRATION

Before Jan. 31, 2018 After Jan. 31, 2018 After April 20, 2018 TOTAL $
Physician / Pharmacist / Corporate
Genetic Counsellor / Nurse
$535 CAN $630 CAN $760 CAN
Post Doc. / Resident1
$510 CAN $605 CAN $720 CAN
Student2
$380 CAN $445 CAN $535 CAN

All fees are shown in Canadian funds. The Full Symposium registration fees includes access to sessions, continental breakfast each day, buffet lunch (May 9-10), coffee breaks and the Symposium documentation.

INDIVIDUAL DAY REGISTRATION

Before Jan. 31, 2018 After Jan. 31, 2018 After April 20, 2018                            
Physician / Pharmacist / Corporate
$415 CAN $440 CAN $475 CAN  
Genetic Counsellor / Nurse
$310 CAN $335 CAN $365 CAN  
Post Doc. / Resident1
$300 CAN $335 CAN $365 CAN  
Student2
$225 CAN $245 CAN $265 CAN  
                                              
$   X    Days =  
Special Intro Workshop
(Tuesday, 7 PM - 9 PM)
(already included in Full Symposium fees)
$50 CAN $55 CAN $60 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 Costs


D. Special Interest Group (SIG) Preferences

Thursday, May 10, 2018

Please rank the SIGs in order of your preference (1-4). You will be assigned to one SIG on a first come-first served basis.

Moderate Risk Genes: risks, counselling and outcomes

Next Generation Tumor Sequencing: beyond tumor genotyping

Surgery for HBOC and its aftermath

Next Generation Genetic Counseling - Tools for Challenging Psychosocial Cases

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, 2018. After February 16, 2018, only 50% will be refunded, and no refunds will be issued for cancellations received after March 16, 2018.


 I have read and acknowledge the cancellation policy.