Defence Medical Association of Canada - AGM 1998 Attendance Registration

AGM 1998 Attendance Registration

Please note this is not a Hotel registration, you should call the Hotel directly
Delta Airport 1-800-668-1444

Name:	Rank:	Active/Retired: ActiveRetired
Street Address:
City:	Prov/State:	Post/Zip Code:
Telephone:	Fax:	Email:
(Please format telephone number as above, and delete format example text before entering information)
DMA Branch or CFMS Unit:
Expected Arrival Date:	Departure Date:

AGM Status: Non DMA Member:

Registration Options:
Complete Package - $110.00 (AGM, Clinical Study, Meet & Greet, Reception, Mess Dinner)
Study Day Only (DMA Members - $40.00, Military Personnal - $50.00, Civilian Personnel - $75.00)
Mess Dinner Only - $65.00
Complete Package plus Additional Mess Dinner Tickets - $110.00 plus (Spouse, Companions or Guests - $65.00 ea)
Study Day plus Mess Dinner - $40.00, $60.00 or $75.00 plus $65.00

Date of Registration:

PLEASE NOTE:

You can either:

1. Fill out the form above on-line, click on submit below and mail your cheque or money order to:

- OR -

2. Print out this form, fill it out and mail a paper copy with your cheque or money order to:

Alberta Branch
Defence Medical Association
11212 36 A Ave
Edmonton, AB
T6J 0E8

Your registration will not be validated until either a cheque or money order has been received by the Alberta Branch Office

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