Registration Form

Event Registration for 32nd Annual CGPA Conference - CGPA-32

32nd Annual CGPA Conference - FREE EVENT

First Name:

Last Name:

E-Mail:

Phone:

Street:

City:

State or province:

Postal/Zip Code:

Organization:

Job Titile:

I am a:



I am registering for:





If you are attending sessions on Thursday, please indicate your level of expertise:



Payment Methods:


I will attend the Gala Wine & Cheese: (Note this is included for Full 2-Day Conference attendees. One day attendees or guests may attend at a cost of $15.00.)



I will attend the Saturday Visioning: (Note this is open to CGPA members only.)


I will attend the Saturday CGPA Annual General Meeting: (Note this is open to CGPA members & interested people. Lunch is provided.)


I consent to the inclusion of my name and contact information in the conference participant list, which may be distributed to the organizers, sponsors, and delegates:


I would like to join the mailing list:


Please indicate if you have any food allergies or other special requirements:

(Only click the Submit Button Once)

Note:

1. Please fill in the registration form first;

2. You may pay the registration fee by Cheque or by Credit Card via PayPal;

By Cheque:
If paying by cheque, please complete this registration form and forward with
your cheque. The Registration Form may be downloaded below. Note the
following:
1. If you are registering at the early booking fee, your cheque must reach our
offices by the early booking deadline.  A 10 day grace period will be allowed
for those booking within the last week of the early booking deadline.
2. If you are registering at the regular booking fee, your cheque must reach
our office at least 10 days prior to the conference date.
3. All cheques must be drawn on a Canadian bank and be in Canadian funds.
4. Please note the registrant’s name on the face of the cheque
Cheques should be made payable to “CGPA.”
5. Payments should be sent to:
                      Alina Isaac
                      89 Wroxeter Avenue
                      Toronto, Ontario M4J 1E7
By Credit Card via PayPal:
If paying by PayPal, after completing the registration form, please pay
registration fee online. Members please use Member Registration Fee Payment.

You may download the Registration Form in PDF Format or Word Format:

PDF Format       WORD Format

ONLINE PAYMENT

Please review the list of options below, highlight the correct option, and click on “Buy Now”.  This will take you to Pay Pal which will allow you to pay with a credit card or your PayPal account.

 

MEMBER REGISTRATION FEE PAYMENT

 

Physicians

 

Mental Health Workers

 

Students or Retirees

 

NON MEMBER REGISTRATION FEE PAYMENT

 

Physicians

 

Mental Health Workers

 

Students or Retirees