CONFERENCE REGISTRATIONMay 13, 14, 15, 2015 – Marriott Château Champlain Montréal, QC
Member Registration Full Conference May 13, 14, 15 $740.00 (includesallsessions,luncheons,coffeebreaks,welcomereceptionandgaladinner) ($985.00AfterMarch16th)
ForthesecondtofourthadditionalFullConferenceregistration, * $540.00 / delegate memberswillreceiveaspecialconferencerateof* ($685.00AfterMarch16th)
ForthefifthandeachadditionalFullConferenceregistration, ** $385.00 / delegate
memberswillreceiveaspecialconferencerateof** ($485.00AfterMarch16th)
One Day Thursday - Includes Gala $485.00 ($585.00AfterMarch16th)
Education Only Option 3-days $585.00 (excludesbotheveningevents)
Non-Member Registration Full Conference May 13, 14, 15 $985.00 (includesallsessions,luncheons,coffeebreaks,welcomereceptionandgaladinner) ($1,185.00AfterMarch16th)
Additional Tickets Wednesday evening cocktail reception tickets $60.00 Additional Gala dinner tickets $95.00
COMPANY INFORMATION(pleaseprintclearly)CompanyName: ContactName: Address
City: Province: PostalCode:
Tel: Email:
PAYMENT INFORMATION(pleaseprintclearly,paymentmustaccompanyapplicationinordertobeprocessed)) Chequeenclosed(chequesshouldbemadepayabletoACSESS)
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 2X7Phone: (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 2X7Phone: (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 2X7Phone: (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
CreditCard#: ExpiryDate: / Signature: SecurityCode(3digits): Nameasitappearsoncard:
Note:CreditcardpaymentwillappearasBB&CManagementServicesInc.onstatements.
Pleasereturnthiscompletedformto:ACSESS,2233ArgentiaRoad,Suite100,Mississauga,ONL5N2X7Tel:(905)826-6869•TollFree:1-888-232-4962•Fax:(905)826-4873
email:[email protected]•web:www.acsess.org
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