Register by March 31st &
June 11th- 14th, 2017, Huntsville, Ontario
Registration Form( Online registration is available at www. amcto. com)
FIRST NAME / INITIAL __________________________________________________________ LAST NAME __________________________________________________________________________ ORGANIZATION ______________________________________________________________ TITLE _______________________________________________________________________________ ADDRESS ___________________________________________________________________ ____________________________________________________________________________________ CITY ____________________________________________________________________________________ PROV ___________ POSTAL CODE ____________________________________________ PHONE(_______) ______________________ FAX(_______) _________________________ EMAIL ______________________________________________________________________________ AMCTO ID # __________________________ IS THIS YOUR FIRST AMCTO CONFERENCE? o YES o NO
IF YOU ARE REGISTERING A COMPANION FOR MEAL OR TOUR PACKAGE PLEASE PROVIDE: COMPANION FIRST NAME _____________________________________________________ COMPANION LAST NAME ______________________________________________________________
Conference Fees o Full Conference Package A. *( Incl Gala & Beach BBQ) Member: $ 862.19 / Non-Member: $ 1065.59 $___________
|
o Full Conference Package B. *( with Gala Dinner)
Member: $ 824.90 / Non-Member: $ 1028.30
|
$___________ |
o Full Conference Package C. *( no Gala Dinner or Beach BBQ) Member: $ 740.15 / Non-Member: $ 920.95 |
$___________ |
|
o Retired Member’ s Meal Package *
$ 293.80
|
$___________ |
|
o Companion’ s Tour Program *
$ 395.50
|
$___________ |
|
o Companion’ s Meal Package *
$ 293.80
|
$___________ |
|
o One Day – Monday, June 12
Member: $ 350.30 / Non-Member: $ 435.05
|
$___________ |
|
o One Day – Tuesday, June 13
Member: $ 350.30 / Non-Member: $ 435.05
|
$___________ |
|
o One Day – Wednesday, June 14
Member: $ 350.30 / Non-Member: $ 435.05
|
$___________ |
Optional Events: Sunday, June 11
AMCTO Golf Tournament o 18-Holes Golf _____ x $ 130.00 = $___________ o Build a Boat Team Building Adventure _____ x $ 100.00 = $___________
Monday, June 12 o Beach BBQ( incl. in Conference Package A and Companions / Retired member packages) _____ x $ 45 = $___________
* Please indicate attendance at the various social events listed below. Opening Reception, Gala Dinner & Reception, and Falls Boat Cruise are included in Full Conference Package A, Retired and Companion Meal Packages. Full Package B includes the Gala but NOT the Beach BBQ. Full Package C and One Day Packages will need to purchase Extra Tickets to attend these event.
Register by March 31st &
You Could Win a Free Registration
Payment Options:
1. Register online if making payment by VISA or MASTERCARD at www. amcto. com
2. Please complete the form and send cheque payment by mail to: AMCTO 610-2680 Skymark Ave Mississauga ON L4W 5L6
Please list any food allergies:
Delegate Attending Companion Attending Purchasing Extra Tickets
Sunday, June 11
Opening Reception o o o ___________ @ $ 55.00
Monday, June 12
Breakfast o o o ___________ @ $ 35.00 Buffet Lunch o o o ___________ @ $ 55.00 Beach BBQ o o o ___________ @ $ 45.00
Tuesday, June 13
Breakfast o o o ___________ @ $ 35.00 Buffet Lunch o o o ___________ @ $ 55.00 Gala Dinner & Reception o o o __________ @ $ 100.00
Wednesday, June 14
Breakfast o o o ___________ @ $ 35.00 Closing Lunch o o o ___________ @ $ 40.00
Refund Policy: All cancellations must be confirmed in writing. A refund levy of $ 113( includes HST) will be applied to every cancellation received up to and including May 6, 2017. No refunds will be made for cancellations received after May 6, 2017. Substitutions are permitted.
Personal Information Protection Policy: This information is collected under the Personal Information Protection and Electronic Documents Act for the purposes of processing your registrations and material delivery. This information is not shared, sold or distributed and is maintained in a confidential and secure manner.
Sub Total: Grand Total:
( All prices Include HST R # 106732936)
$ __________________ $ __________________
2680 Skymark Ave., Suite 610, Mississauga, Ontario L4W 5L6 Tel:( 905) 602-4294 Fax:( 905) 602-4295 Email: amcto @ amcto. com Web: www. amcto. com
Municipal Monitor 23