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ROCKY MOUNTAIN GORILLA WORKSHOP

                              JUNE 25 28th, 2004

                           Calgary, Alberta, Canada

                           REGISTRATION FORM

 

Name :  

Title:  

Institution:

Mailing Address:     

City: 

State/Prov:    

Postal Code:      

Phone:  

Fax:

e-mail:

 

Full

Registration Fees

Daily

Registration Fees

Events & Activities

Early Bird

(before January 1, 2004)

 

 

$100.00    

Friday   Saturday

Sunday  Monday 

     $50.00/day   

 

June 25, 2004: Preconference trip to the Tyrell Museum of Paleontology

          $45.00       

 June 29, 2004: Postconference trip to Banff National Park 

          $45.00       

 

Open Registration

(January 2nd to April 30, 2004)  

 

$150.00     

 

$75.00/day    

Late Registration

(May 1st to June 10th, 2004)*

 

$200.00     

 

$100.00/day  

Subtotal

$   

$  

$  

 

Grand Total   $                                All Fees are in US Dollars.

*Please note registrations will not be accepted after June 10th, 2004.

Fees are non-refundable after April 30th.  

Requests for refunds must be made in writing.

Paying by Credit Card?

Name on Credit Card:    

Visa    Mastercard 

American Express 

Credit Card Number:     

Expiry date:     

Signature of Registered Cardholder:

Please fax completed form to Garth Irvine at (403)237-7582, or mail to Garth Irvine, Calgary Zoo, 1300 Zoo Road NE, Calgary, AB   T2E 7V6 Canada

 

Paying by check or money order?

Please make payable to the Calgary Zoological Society, then mail completed form and payment to Garth Irvine, Calgary Zoo, 1300 Zoo Road NE, Calgary, AB  T2E 7V6 Canada

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