MEDIA REGISTRATION FORM FOR HEALTHACHIEVE 2017
Thank you for your interest in HealthAchieve 2017 which will take place on November 6 & 7, 2017.
Media are welcome to attend the show at no charge. However, we do request that all media personnel pre-register and
complete the form below. Once the form is completed, please email it to [email protected].
You will then be contacted by our office to obtain more details.
On-site at the show, you must proceed to the Media Registration Desk.
Make sure to bring ID to the show, such as:
- Business card indicating name, media and company name, position; and a business Photo ID Card
__________________________________________________________________________________________
First and Last Name:
(Please type or print)
Position: ______________________________________________ Department:
Company Name:
Mailing Address:
City/Town:
Telephone: (
Province/State:
)
Postal/Zip Code:
Email:
Company’s Website:
Which day(s) are you planning to attend HealthAchieve?
 Monday November 6
 Tuesday November 7
Areas of Interest – please indicate the session/s and/or speaker/s, etc. you are interested:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
For more information, please contact:
HealthAchieve 2017
ATTENTION: JENNIFER HALL
200 Front Street West, Suite 2800
Toronto, Ontario, M5V 3L1
Tel: 416-205-1434; Fax 416 205-1340
E-mail: [email protected]