72nd Conference Registration Form
First Name
*
Last Name
*
Telephone Number
*
Email Address
*
I am a Member or a Guest
*
Member
Guest
I am a Member or Guest of BPW
*
Barrie
Belleville
Bowmanville
Brampton
Cambridge
Durham
Kitchener/Waterloo
London
Mississauga
Niagara Falls
North Toronto
Ottawa
Sault Ste. Marie
St Catharines
Sudbury
Trenton & District
Please Pick one
I am a member of the Ontario Provincial Board
*
Yes
No
Piease Pick One
I will be attending
*
Early Bird Full Conference Price: $275.00 (Valid till April 30, 2018)
Full Conference Regular Price: $335.00 (Effective from May 1, 2018)
Day 1 (Saturday) Conference Only: $150.00
Day 1 (Saturday) Conference + Gala Dinner: $240.00
Day 1 (Saturday) Gala Dinner Only: $90.00
Day 2 (Sunday) Conference Only: $100.00
Day 2 (Sunday) Conference + (Saturday)Gala Dinner: $190.00
Please Pick one
I will be paying by
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Email Interac
Cheque
Part of a group payment - Email Interac
Part of a group payment - Cheque
Please Pick one
Saturday Night Gala Dinner Entrée Preference
*
Chicken
Fish
Vegetarian
Please Pick one
Special Dietary Requirements
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None
Gluten Free
Lactose Free
Vegan
Vegetarian
Other
I will be booking a room at the Hotel Holiday Inn
*
Yes
No
Please Pick one
I hereby give consent for BPW to use my personal information on this registration form and/or use my image in photographs for the sole purpose of promoting benefits of membership within BPW
*
Yes
No
Please Pick one
Submit
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