CONFERENCE REGISTRATION ACSESS Annual Conference - MAY 11 ¢â‚¬â€œ 13, 2011 THE HOTEL OMNI MONT ROYAL MONTREAL

CONFERENCE REGISTRATION ACSESS Annual Conference - MAY 11 ¢â‚¬â€œ 13, 2011 THE HOTEL OMNI MONT ROYAL MONTREAL

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  • CONFERENCE REGISTRATION May 13, 14, 15, 2015 – Marriott Château Champlain Montréal, QC

    Member Registration Full Conference May 13, 14, 15 $740.00 (includes all sessions, luncheons, coffee breaks, welcome reception and gala dinner) ($985.00 After March 16th)

    For the second to fourth additional Full Conference registration, * $540.00 / delegate members will receive a special conference rate of * ($685.00 After March 16th)

    For the fifth and each additional Full Conference registration, ** $385.00 / delegate

    members will receive a special conference rate of ** ($485.00 After March 16th)

    One Day Thursday - Includes Gala $485.00 ($585.00 After March 16th)

    Education Only Option 3-days $585.00 (excludes both evening events)

    Non-Member Registration Full Conference May 13, 14, 15 $985.00 (includes all sessions, luncheons, coffee breaks, welcome reception and gala dinner) ($1,185.00 After March 16th)

    Additional Tickets Wednesday evening cocktail reception tickets $60.00 Additional Gala dinner tickets $95.00

    COMPANY INFORMATION (please print clearly) Company Name: Contact Name: Address

    City: Province: Postal Code:

    Tel: Email:

    PAYMENT INFORMATION (please print clearly, payment must accompany application in order to be processed)) Cheque enclosed (cheques should be made payable to ACSESS)

    OR

    ACSESS Annual Conference - Congrès annuel “Youth of Today – Leaders of Tomorrow” Les jeunes d’aujourd’hui – les leaders de demain

    MAY 11 – 13, 2011 THE HOTEL OMNI MONT ROYAL MONTREAL

    Sponsorship Opportunities: Please select your choice of sponsorship and complete the payment form below.

    Company Name

    Contact Name

    Address

    City

    Province Postal Code

    Tel:

    Email:

    Company Information (please print clearly) Payment Information (please print clearly) PAYMENT MUST ACCOMPANY APPLICATION IN ORDER TO BE PROCESSED

    Cheque enclosed (cheques should be made payable to ACSESS)

    OR

    Credit Card #

    Expiry Date /

    Signature:

    Name as it appears on card:

    Note: Credit card payment will appear as BB&C Management Services Inc. on statements.

    Please return this completed form to: ACSESS, 2233 Argentia Road, Suite 100, Mississauga, ON L5N 2X7 Phone: (905) 826-

    All sponsorships confirmed and paid in full by February 7, 2011 will be eligible for a 20% discount on advertising in the Spring pre-conference issue of Dialogue magazine.

    DIAMOND - $10,000

    PLATINUM - $5000

    GOLD - $2500

    SILVER - $1000

    ADDITIONAL SPONSORSHIP OPTIONS

    NAME BADGES - $2500

    DELEGATE BAGS - $1500

    AWARDS BANQUET - $1000

    WINE / SOCIAL / MEAL

    ACSESS Annual Conference - Congrès annuel “Youth of Today – Leaders of Tomorrow” Les jeunes d’aujourd’hui – les leaders de demain

    MAY 11 – 13, 2011 THE HOTEL OMNI MONT ROYAL MONTREAL

    Sponsorship Opportunities: Please select your choice of sponsorship and complete the payment form below.

    Company Name

    Contact Name

    Address

    City

    Province Postal Code

    Tel:

    Email:

    Company Information (please print clearly) Payment Information (please print clearly) PAYMENT MUST ACCOMPANY APPLICATION IN ORDER TO BE PROCESSED

    Cheque enclosed (cheques should be made payable to ACSESS)

    OR

    Credit Card #

    Expiry Date /

    Signature:

    Name as it appears on card:

    Note: Credit card payment will appear as BB&C Management Services Inc. on statements.

    Please return this completed form to: ACSESS, 2233 Argentia Road, Suite 100, Mississauga, ON L5N 2X7 Phone: (905) 826-

    All sponsorships confirmed and paid in full by February 7, 2011 will be eligible for a 20% discount on advertising in the Spring pre-conference issue of Dialogue magazine.

    DIAMOND - $10,000

    PLATINUM - $5000

    GOLD - $2500

    SILVER - $1000

    ADDITIONAL SPONSORSHIP OPTIONS

    NAME BADGES - $2500

    DELEGATE BAGS - $1500

    AWARDS BANQUET - $1000

    WINE / SOCIAL / MEAL

    ACSESS Annual Conference - Congrès annuel “Youth of Today – Leaders of Tomorrow” Les jeunes d’aujourd’hui – les leaders de demain

    MAY 11 – 13, 2011 THE HOTEL OMNI MONT ROYAL MONTREAL

    Sponsorship Opportunities: Please select your choice of sponsorship and complete the payment form below.

    Company Name

    Contact Name

    Address

    City

    Province Postal Code

    Tel:

    Email:

    Company Information (please print clearly) Payment Information (please print clearly) PAYMENT MUST ACCOMPANY APPLICATION IN ORDER TO BE PROCESSED

    Cheque enclosed (cheques should be made payable to ACSESS)

    OR

    Credit Card #

    Expiry Date /

    Signature:

    Name as it appears on card:

    Note: Credit card payment will appear as BB&C Management Services Inc. on statements.

    Please return this completed form to: ACSESS, 2233 Argentia Road, Suite 100, Mississauga, ON L5N 2X7 Phone: (905) 826-

    All sponsorships confirmed and paid in full by February 7, 2011 will be eligible for a 20% discount on advertising in the Spring pre-conference issue of Dialogue magazine.

    DIAMOND - $10,000

    PLATINUM - $5000

    GOLD - $2500

    SILVER - $1000

    ADDITIONAL SPONSORSHIP OPTIONS

    NAME BADGES - $2500

    DELEGATE BAGS - $1500

    AWARDS BANQUET - $1000

    WINE / SOCIAL / MEAL

    Credit Card #: Expiry Date: / Signature: Security Code (3 digits): Name as it appears on card:

    Note: Credit card payment will appear as BB&C Management Services Inc. on statements.

    Please return this completed form to: ACSESS, 2233 Argentia Road, Suite 100, Mississauga, ON L5N 2X7 Tel: (905) 826-6869 • Toll Free: 1-888-232-4962 • Fax: (905) 826-4873

    email: acsess@acsess.org • web: www.acsess.org