events registration form

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EVENTS REGISTRATION FORM

Contact Information * Required information (if not applicable, enter N/A)
Organization:*
Contact person:	Name* Position	Phone number* Fax number* Email address*
Membership status:*
Address:	(fill in address only if you are not a QNET member) Street
	City	Province
	Postal Code

Registration

Purchase Order Number (if required):

Special invoicing / payment instructions:
(You can pay by VISA, AMEX or MasterCard on the invoice you receive from the QNET office)

Is your organization GST exempt?

Yes

Event*

* You can only register for one event at a time. To register for another event after you have submitted this form, hit the back button on your browser.

Attendees
Number of individuals from your organization attending:
List of Attendees: (Please provide: Name, phone #, fax #, and email. Please provide address if different from contact person. )

You will be invoiced for the total amount of the registrations plus G.S.T. If you have any questions, email QNET at mail@qnet.mb.ca or phone QNET at (204) 949-4999.

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