Carolinian Canada Coalition

'CARING FOR OUR COAST'
Oct 22nd - 23rd, 2009

Pt. Pelee National Park & Pelee Dys Inn

Leamington, Ontario

Forum 2009 Registration

Please fill in the fields below, submitting one form per registrant. Click the Submit Registration button once to register. Note: We do not collect GST.

Book your room at the Pelee Days Inn. Special Conference rate is $76 a night. Reserve early, call 1-519-326-8646 and quote "Carolinian Canada Conference"

First Name

Last Name

Organization 

include organization name in address

Phone Number

Email

Mailing Address

City

Province / State

Postal / Zip Code

Carolinian Canada 2009-10 Membership

Current Member     
$10 Student  

$20 Individual/Family   

$50 Organization

Before October 15th, please send cheque to:

Carolinian Canada Coalition

1017 Western Rd.

London, ON

N6G 1G5

After October 15th, please bring your cheque to the meeting.

Cheques are to be made payable to  Carolinian Canada Coalition.

Payment & Registration

Payment will be mailed by October 15th

On-site Cash or Cheque, after October 15th

Pre-registration by email: office@carolinian.org by Oct. 21st
Pre-registration by fax: 519-913-2449 by Oct. 20th

Sorry, credit cards are not accepted

Please click once to submit your registration.

CCC Forum 2009 2-day packages
(includes workshops and banquet)

$250 General

$200 Early Bird by September 15th    

Thursday

$120 Workshops

$55 Banquet and Keynote Speaker

Friday

$100 Workshops (includes lunch)

Special

Speaker
Day: Thursday Friday Banquet

Add

$25 Late fee after October 15th

$20 Non-member fee

$25 "Caring for our coast" eco-shirt size:
$20 Forum Proceedings

Displays

$500-5,000 Forum Sponsor Display (see sponsor package here)

$50 Member non-profit table (shared)
Table Floor Exhibit

Total Charge: $

Please indicate your preferences

Thursday outdoor workshops: rank your preference from 1-4 (1 being your 1st choice, and so on)

Coastal Processes
Species at Risk
Park Trails
Community Trails

Provide a 5-minute update about your project (optional) - your topic:

Please indicate:

Vegetarian

Special Dietary requirements:

I do not want my name included in the participants' list