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Registration Form

37th AMOP Technical Seminar on Environmental Contamination and Response
June 3 to 5, 2014
Radisson Hotel and Conference Centre
Canmore, Alberta, Canada

Print and submit

Name _________________________________________________________________________

Organization ___________________________________________________________________

Street ________________________________________________________________________

City _____________________________________   Province/State ______________________

Country __________________________________   Postal Code/Zip _____________________

Telephone ________________________________   Fax _______________________________

E-mail ________________________________________________________________________

Registration Packages and Rates

Complete  Package (includes sessions, poster displays, exhibits, coffee breaks, and lunches for all 3 days, Welcome Reception, and a copy of the Proceedings)

☐ Before May 1- $475*

☐ After May 1 - $575*

☐ On site - $650**

 

Daily Rate

MondayTuesdayWednesday

☐ Before May 30 (____ x $225*) = $__________*

☐ On site (____ x $255**) = $__________**

 

Student Rate

☐ Before May 30 - $275*

☐ On site - $310**

 

* 13% HST extra , if applicable | ** includes taxes


All prices are in Canadian dollars. To receive the reduced registration rate, payment must be received by May 1, 2014. Make cheques payable to Receiver General for Canada and send along with this form.
If paying by credit card, please fill out the information below.

☐ Cheque       ☐ Visa       ☐ MasterCard       ☐ AmEx          

Total Amount (Canadian Dollars) ________

Card Number:   _____________________________________
Expiry Date: ____________
Card Security Code (Last 3 digits on the back of the credit card): __________
Name as it appears on card: ______________________________________
Authorization signature:   ________________________________________

Send this form along with payment to:

Natalie Jones
Technical Seminar Coordinator
Emergencies Science and Technology Section
Environment Canada
335 River Road
Ottawa, Ontario, Canada K1A 0H3
Telephone: (613) 991-1114
Fax: (613) 991-9485
E-mail: SpillSeminars@ec.gc.ca

Please contact us if you have any questions.

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