Registration - Congrès RPCU 2023

1. COMMITTEE IDENTIFICATION : BILLING AND PAYMENT

Your region

Committee name

Committee number

Membership status

Committee address

Room

Local

City

Province

Postal code

Contact person

First name

Last name

Phone number/Cell phone

Committee e-mail

Language

Français

English

Changement de statut

Status change : I certify that the committee to which I am a member has renewed its 2023-2024 RPCU membership, but this registration form is not updated. I understand that the change I make to this form is subject to verification by the RPCU.

2. PARTICIPANT IDENTIFICATION

If you do not yet know the identity of the participant, please add Participant 1 and the committee email.

Section 1

Last name

First name

Last name

E-mail

Phone number/Cell phone

Participant Committee

Mobility information

I am a person with functional limitations

Oui / Yes

Non / No

Limitation

Specify

I need help and support for mobility and getting around

Oui / Yes

Non / No

Mobility

Specify

Considering my needs

The name and contact details of my companion or interpreter are :

Last name

First name

Last name

Phone number

E-mail

Traduction

Simultaneous translation into English would help me to better participate in this congress.

Do you have any dietary constraints or restrictions?

Dietary constraints

Oui / Yes

Non / No

Constraints

Specify

Mes choix d'ateliers

My choice of workshop A My choice of workshop A

My choice of workshop B My choice of workshop B

Cost per participant

Tarif membres: $ 521.85 CAD

Cost per participant

Tarif membres: $ 521.85 CAD

TPS Members

TPS: $ 26.09 CAD

TPS Members

TPS: $ 26.09 CAD

TVQ Members

TVQ: $ 52.06 CAD

TVQ Members

TVQ: $ 52.06 CAD

Cost per participant

Tarif non-membres: $ 630.57 CAD

Cost per participant

Tarif non-membres: $ 630.57 CAD

TPS Non-Members

TPS: $ 31.53 CAD

TPS Non-Members

TPS: $ 31.53 CAD

TVQ Non-Members

TVQ: $ 62.90 CAD

TVQ Non-Members

TVQ: $ 62.90 CAD

Add a participant Remove a participant