NCIDQ Practice Sessions


Type info into fields below, then print form and fax to: 416.921.3660
Note: Information inputted below is for print purposes only and is not transmitted through the internet.

Registration Form

     
Provisional members fee $175 x
Non-members fee $275 x
 
HST 12%=
Total =

Payment Information:

Member Name :
Member Number :

Main contact info:

Phone:   Fax:  

E-mail:

Visa   MC   AMEX   Cheque

Credit Card Number:   Exp:

Name on Credit Card:  

Signature:
(Please sign manually on printed copy prior to faxing.)

Make cheques payable to IDC. HST#10250 6243 RT0001


Registration deadline is one week before the seminar/event. A $20 fee will be charged for cancellations received less than one week prior. Substitutions are permitted at any time prior. No refunds will be made after the seminar/event has occurred.