CPS PRINTABLE REGISTRATION

All prices in Canadian Dollars:

2 Day Delegate Fee ________ X $245= $__________ includes lunches, nutritional breaks, banquet and auction

1 Day Delegate Fee ________ X $130= $__________ includes lunch and nutritional breaks

Indicate which day you will attend: Saturday ________ Sunday _________

Additional Banquet/Auction Ticket ________ X $ 50= $__________

Additional banquet registration may be limited, early registration is recommended

Published Proceedings ________ X $ 20= $______

Delegate Name: _____________________________________________
_____________________________________________

Additional Delegates: _____________________________________________
_____________________________________________

Address: _____________________________________________
_____________________________________________
City: _______________________________

Prov/State: _____ Postal Code: _________

Country: _______________

Phone: _____________________________

Fax: _____________________________
Email: _____________________________


Payment Made By:
Cheque____ Money Order____ Cash______
Visa____ MasterCard____

Card#________________________________
Expiry Date_______________________
Signature________________________

Please tell us where you first heard about the Symposium:_____________________________

For more information on the Canadian Parrot Symposium, the society and accommodations visit our website at:

www.parrotsymposium.com

Mailing Address:
Canadian Parrot Symposium
P.O. Box 35065 Hillside Postal Outlet
Victoria BC V8T-5G2
Fax: 250-477-9935

Email: Canadian Parrot Symposium