Conference Registration form

22nd North American Mushroom Conference
Vancouver, British Columbia, Canada
June 22-24, 2013

Instructions

One person or couple per form.
Hotel reservations should be made directly with the Westin
Bayshore 1 (604) 682-3377 or online.
The Early Bird registration deadline is January 15, 2013. Registrations
received after this date will not be included in the Early Bird Draw.
Confirmation of registration will be sent by Mushrooms Canada office.

If you are paying by cheque, please mail your payment to:
Mushrooms Canada
7660 Mill Rd. R.R.#4, Guelph, Ontario, Canada N1H 6J1
Fax: 519.837.3369 Tel: 519.829.4125

Badge Information

Name*

Name of Companion (if attending)

Company

Address*

City*

Province/State*

Country*

Postal Code/Zip Code*

Telephone*

Fax

Email

Registration Categories

Please check the categories below you wish you register for.

Member: $695.00

Member Companion:$400.00

Non-Member:$895.00

Non-Member Companion:$550.00

Registration Fees

Member rates apply to members of Mushrooms Canada, the American Mushroom Institute
and other recognized national grower associations.

I want to pay by: Cheque Credit Card / Paypal
Please indicate your payment method.

You have chosen to pay by credit card. Please click the continue button below to go to
PayPal to make your payment.

While PayPal is our payment processor, you do not need a PayPal account to make your payment.
PayPal accepts payments from all Visa, MasterCard, Discover and American Express cards,
as well as some other localized payment types.

Cancellations

All refund requests must be submitted in writing.
A fee of $75.00 will be deducted on all cancellations
received before April 30, 2013. No refunds for
cancellations after that date or no-shows at
the conference.

SUBTOTAL: $0
13% HST (If Canadian): $0
TOTAL: $0