2009 CTSA Convention Registration

Halifax Marriott Harbourfront; June 4 - 7, 2009

Please be aware:
1)  The pre-registration period deadline of Friday, May 1st has passed; please use this form
for pre-arrival registration (PayPal) or on-site registration in Halifax (checks, cash, PayPal).
The CTSA office is NO LONGER ACCEPTING MAILED REGISTRATIONS.
Please use this form and process your registration and payments now (through secure PayPal) or at the registration table in Halifax (using check, cash, secure PayPal).
2)  No refunds will be processed after May 28, 2009. All refunds are subject to a $20 processing fee.
3)  Check and cash payments must be made in Halifax at the registration table;
Check payments must be made payable to CTSA; US dollars only.

Attendee Name:
    print as you wish your name to appear on name badge
     
Institution;
or city of residence:
     
Telephone #: ( ) , ext.
Email Address:
     
Please select from the registration options below.
  $150 Member Registration
  $75 Spouse non-member Registration;
   spouse name (for badge):
  $170 Non-Member Registration
  $35 Student Registration; ID must be presented on site
  $60 Convention Registration; Thursday only
  $60 Convention Registration; Friday only
  $60 Convention Registration; Saturday only
  
  $70 Saturday Banquet ticket; must select entree next line
      Select Entree: meat; fish, vegetarian, or vegan entree
    $70 Additional Banquet Ticket(s); select quantity & entree below
       Number of additional Banquet tickets
  Select Entree(s):
    Donation towards Student Banquet Ticket $
    $25 Rahner Society Breakfast (Saturday, June 6th)
    $25 Additional Rahner Society Breakfast; select quantity below
       Number of additional Rahner Society Breakfast tickets
    $25 Women's Luncheon (Friday, June 5th)
    $25 Additional Women's Luncheon; select quantity below
       Number of additional Women's Luncheon tickets
    $20 Women's Luncheon; Student Price (Friday, June 5th)
     
Please note: any dietary concerns or any questions should be directed to:
CTSA Secretary, Mary Jane Ponyik at (216) 397-4980
     
Payments Options
     $0.00  Total amount due for registration selections
    Pay online securely using PayPal
    Print this completed form & bring it with you
to Halifax to make payment by check or cash at the registration table.
     

 

 
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