Delegate Registration Form
STEP 1: Personal Details
(Please print clearly)
☐ Prof.
☐ Dr.
☐ Mr.
First Name:
Click here to enter text.
Title: Click here to enter text.
☐ Mrs.
☐ Ms. (please check one)
Last Name: Click here to enter text.
Company: Click here to enter text.
Address: Click here to enter text.
City: Click here to enter text.
Prov/State: Click here to enter text.
Country: Click here to enter text.
Postal Code/Zip: Click here to enter text.
Phone: Click here to enter text.
Fax: Click here to enter text.
Email: Click here to enter text.
STEP 2: Select registration category
Please check one of the following that best describes you:
☐ Primary Producer
☐ Packer/Processor
☐ Feedlot Backgrounder
☐ Government
☐ Retail/Food Service
☐ Financial Institution
☐ Agri-business
☐ Industry Association
☐ Student/Educator/Research
☐ Other: Click here to enter text.
Registration Times:
Tuesday, November 18, 2014 from 7:00 pm – 9:00 pm
Wednesday, November 19, 2014 from 7:00 am on throughout the day.
Session Times:
Tuesday, November 18, 2014, Opening Reception & Guest Speaker 7:00 pm – 10:00 pm
Wednesday, November 19, 2014, Breakfast 7:00 am – 8:00 am; Forum 8:00 am – 5:00 pm
Registration fee includes the Tuesday reception cost (cash bar is available) and the Wednesday continental
breakfast, 2 coffee breaks and lunch.
Early registration prior to September 6, 2014
Canfax Member, Producer:
$238.75 plus GST
Canfax Member, Industry:
$259.75 plus GST
Canfax Member, Government:
$259.75
Non Member, Primary Producer:
Non Member, Industry:
Non Member, Government:
$291.25 plus GST
$312.25 plus GST
$312.25
Full registration after September 6, 2014:
Canfax Member, Primary Producer:
$265.00 plus GST
Canfax Member, Industry:
$286.00 plus GST
Canfax Member, Government:
$286.00
Non Member, Primary Producer:
Non Member, Industry:
Non Member, Government:
STEP 3: Registration
$317.50 plus GST
$338.50 plus GST
$338.50
Early Bird
Before
September 6, 2014
Canfax Member, Primary Producer:
$250.69
($238.75 plus GST)
Canfax Member, Industry:
$272.74
($259.75 plus GST)
Canfax Member, Government:
Non Member, Primary Producer:
$259.75
$305.81
($291.25 plus GST)
Non Member, Industry:
$327.86
($312.25 plus GST)
Non Member, Government:
Grand Total
$312.25
Registration
Total Due
After
September 6, 2014
CDN funds
$278.25 Click here to enter text.
($265.00 plus GST)
$300.30 Click here to enter text.
($286.00 plus GST)
$286.00 Click here to enter text.
$333.38 Click here to enter text.
($317.50 plus GST)
$355.43 Click here to enter text.
($338.50 plus GST)
$338.50 Click here to enter text.
$ Click here to enter text.
All payments must be made in Canadian funds.
Registration will not be processed or acknowledgement sent until payment is received. GST# 893865915
STEP 3: Method of Payment
Please choose one form of payment, tick “x” where applicable and complete the details below.
☐1. Pay by Cheque
Make cheque payable to “Iris Meck Communications Inc.” (with a memo of CANFAX Forum) in Canadian funds
with all the correct information included and mailed with a copy of the registration form to:
CANFAX Cattle Market Forum
c/o Iris Meck Communications Inc.
Suite 510, 5920 - 1 A Street SW
Calgary, Alberta, Canada T2H 0G3
☐2. Pay by Credit Card
(Please check one)
☐VISA
☐MasterCard
Credit Card number: Expiry Date (MM/YY): Click here to enter text.
Security code (CCV) on back of card: Click here to enter text.
Name as it appears on the front of the card: Click here to enter text.
☐ I authorize the use of my credit card
(By agreeing, you authorize the use of your credit card. Your credit card statement will read “Iris Meck
Communications Inc.”)
Cancellation Policy
No refunds will be processed, however, you can substitute attendees by contacting the Canfax Forum office by
phone at: 403-686-8407, fax: 403-255-4592 or by email at: [email protected]
Dietary Restrictions
Please advise of any food restrictions or dietary requirements that need to be met:
Click here to enter text.
Registration Deadline
Registration by phone or fax will close Monday November 17, 2014 at 4:30 pm. Registration will resume and
will be accepted on-site Tuesday November 18, 2014 at 7:00 pm.