Registration (2015) | Atlantic CLRA

Title

Last Name *

First Name *

Company/Organization

Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Phone *

Fax

Email *

Select Registration Package *

If you selected the "Multiple" package option, please list the name of the General registrant who will be attending the conference. Please note that the General registrant fee is still $200 when the Multiple option is selected.General $200Student $1001 Day $125Multiple (2 Days) $150**

** Multiple registrants for one organization

If you selected the "Multiple" package option, please list the name of the General registrant who will be attending the conference.

Will you be attending…

Industry-Research Connector Event – Wednesday Oct 21Tour of Mactaquac Dam after the conference presentations, Thursday October 22 9am - 10:30am

Allergies/Dietary needs

The list of registrants will be available.

If you would NOT like your contact information made available to the public, please check this box.

Payment Instructions If you wish to pay by credit card, select PayPal. You will receive a money request which you can then pay by credit card. Please make cheques payable to CLRA Atlantic and mail to Diane Praught at 1103-2677 Gladstone Street, Halifax, NS, B3K 0A3.

Payment Options *

Please select one:PayPalMail-in cash or chequeIn person at conference

ARC 2015 Conference
October 20-22 Registration Includes: Two full days of presentations (Tuesday and Wednesday, October 20-21). Lunch and nutrition breaks Prices include taxes. Multiple registration discount: For the second or more registrant from the same organization or Branch of Government. Does not include membership in the National Organization. For example, Company X with two attendees will pay $350 and Company Y with three attendees will pay $500.00. Optional tour to the NB Power Mactaquac Dam (Thursday, October 22).
Registration Type	Price
GENERAL – 2 day and includes membership in CLRA National.	$200
STUDENT – 2 day and includes student membership in CLRA National	$100
1 DAY – 1 day, does not include membership in CLRA (either Tuesday October 20 or Wednesday October 21)	$125
MULTIPLE – 2 days	$150
INDUSTRY-RESEARCH CONNECTOR EVENT – Wednesday Oct 21	No charge
TOUR – Tour of Mactaquac Dam after the conference presentations, Thursday October 22 9am – 10:30am	No charge

2015 Registration Form

Verification

If you choose the PayPal option, you will receive a money request in your email.