WE INVITE YOU TO JOIN US! - The Canadian Association of ...

FRIDAY, NOVEMBER 4, 2011 RITZ-CARLTON HOTEL, TORONTO
YES, I will attend as indicated below
Regrets, I cannot attend
Full name:
Academic affiliation and title:
Hospital affiliation and title:
Mailing address:
PARTICIPANT INFORMATION (please print or type)
Degrees/Designations:
City: Province: Postal Code:
Phone: Fax: E-mail:
Preferred method of communication: E-mail Fax & phone Other (specify):
Allergies, special dietary requests:
FEES (Registration fee per delegate, per day, includes breakfast / am & pm breaks, lunch, meeting materials and post-adjournment reception)
EARLY-EARLY BIRD Registration Discount
(Before June 30, 2011)
EARLY BIRD Registration Discount
(Before August 1, 2011)
REGISTRATION
(After August 1, 2011)
Physicians & Surgeons $150.00 $175.00 $225.00
Allied Healthcare Professionals
Postgraduate Residents & Fellows
YES, I will attend post-meeting reception at 4:45 pm
$65.00 $75.00 $95.00
NO, I will not attend post-meeting reception
PAYMENT
Cheque enclosed payable to: Catrile & Associates Ltd., 1B-391 Berkeley Street, Toronto, Ontario M5A 2X8
Credit card: VISA MasterCard
Card number:
Cardholder name:
Expiry date:
Cancellation/Refund Policy: A $50.00 administrative fee will apply to cancellations received in writing on or before October 15, 2011.
No refund policy is applicable to cancellations received after October 15, 2011.
ACCOMMODATION ( The Ritz-Carlton, Toronto www.ritzcarlton.com/toronto )
To make your reservations, call 1-800-542-8680 by 5:00 pm EST, Thursday, September 1, 2011
Refer to Mentoring in IBD to obtain the very special rate of $230.00/night single/double occupancy (plus applicable taxes), including complimentary
high-speed internet access. Please note the special rate is available 3 days pre- and 3 days post-November 4, 2011.
To register for Mentoring in IBD please complete this form and fax to Catrile & Associates Ltd. at 416 519-0243.
Email to: catherine.riley@rogers.com Telephone: Catherine Riley at 647 261-3997.
Registration is limited and on a first-come, first-served basis.