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CONGRESS – Vancouver, April 25-26, 2020
(Registration form)

Type of registration*
- Member or non-member
- Exhibitor
Last name*
First name*
Company*
Authorized person*
*
Address (office) City Province Postal code Country
Office phone*
Cell.
Fax
*
Email Confirm email
Product(s) and/or services
Saturday – Sunday (April 25-26, 2020)
Are you a Member of the CSP?*
Are you Physician, Speaker, RN, Resident, Allied Health Professional or are you attending for the first time?*
Are you Physician, Speaker, RN, Resident, Allied Health Professional or are you attending for the first time?*
Saturday Dinner (Blue water Cafe)*
Saturday Dinner – Number of persons*
Price: $ 125.00 CAD Quantity:
Saturday Dinner – Total
Category

Amount
Congress Fee – Member

2 300,00 $
Congress Fee - Speaker, RN, Resident, Allied Health Professional

1 400,00 $
First time attendance

500,00 $
Congress Fee - Not a Member

2 685,00 $
Congress Fee - Speaker, RN, Resident, Allied Health Professional

1 785,00 $
Saturday Dinner (Blue water Cafe)

0,00 $
Total
$ 0.00 CAD
Saturday – April 25, 2020
Exhibition (Saturday only)
Price: $ 2,300.00 CAD
Saturday Dinner (Blue water Cafe)*
Saturday Dinner – Number of persons*
Price: $ 150.00 CAD Quantity:
Saturday Dinner – Total
Category

Amount
Exhibition (Saturday only)

2 300,00 $
Saturday Dinner (Blue water Cafe)

0,00 $
Total
$ 0.00 CAD
Payment
Payment methods*
- Credit card
- Cheque
Credit card*

Card Details

Cardholder Name
We reserve the right to cancel or make changes.
Make the cheque payable to «Canadian Society of Phlebology» and send it to the mailing address listed below.
Do not forget to include with your payment a copy of the registration form that you will receive by email.

Canadian Society of Phlebology
90 Lansdowne Street
St-Bruno, QC
Canada J3V 0B3

CONGRESS – Vancouver, April 25-26, 2020(Registration form)

Saturday – Sunday (April 25-26, 2020)

Saturday – April 25, 2020

Payment

CONGRESS – Vancouver, April 25-26, 2020
(Registration form)