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Online Registration Form

Date: Thursday, September 18, 2008
Place: Bingemens Conference Centre
425 Bingeman Centre Drive,
Kitchener, Ontario
Time: 8:30 am to 4:30 pm

Personal Information

Name
Business
Address
City
Postal
Phone
E-Mail
E-Mail (Confirm)
Please list any food allergies/intolerances/preferences
 

Please register me for:

  Description Unit Price Quantity  
Individual ticket(s) $ $
Table (8 tickets) $ $
      Sub-Total $
      GST (5%) $
      Total $

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