Registration Form

A. Identification

B. Perspective

Medical Speciality:
Professional License Number


C. Registration Fees (virtual participation)

FULL SYMPOSIUM REGISTRATION

Before March 12, 2021 After March 12, 2021 TOTAL $
Physician / Corporate Rep.  

Registration

closes

April 16,

2021

Genetic Counsellor / Nurse  
$560 CAN $600 CAN
Post Doc. / Resident1
$540 CAN $580 CAN
Student2
$390 CAN $420 CAN

All fees are shown in Canadian funds. The Full Symposium registration fees includes access to sessions, poster sessions, exhibitors and the Symposium documentation.

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 a letter from your programme director or your institution's registrar.




Total Registration Fees



D. Special Interest Group (SIG) Preferences

Please select your preferred SIG for each session.

 

Wednesday SIG:  SIG 1:  Moderate risk genes – When and where are they useful? 
 SIG 2: Ethico-legal issues around usage of genomic data   

Thursday SIG:  SIG 3: Rarer moderate to highly penetrant breast cancer syndromes – CDH1, PTEN, TP53, NTHL1
 SIG 4: Genetic counselling – How to expect the unexpected?   

Friday SIG:  SIG 5: Hereditary prostate, pancreatic and male breast cancer: Research updates and surveillance recommendations
 SIG 6: Ovarian cancer – a multi-faceted view             

E. Special Note



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 / Committee Member

Cancellation Policy

Full refunds, less an administrative fee of $50.00, will be made for written cancellations received by March 12, 2021. No refunds will be issued for cancellations received after March 12, 2021.



 I have read and acknowledge the cancellation policy.