SLATE Registration Form

Your Name:                                                                        

Your Organization:                                                           

Your Position / Role:                                                

Your: Address:                                                                   




Your Phone Number:                                                       

Your Email Address:                                                        


We / I plan to attend:                                                                                

"Meet and Greet"    Wine and Cheese Reception   April 15, 2012    2:00 pm - 5:00 pm
Day Conference                                                           April 16, 2012    8:30 pm - 4:00 pm
 
    Number of Guests Attending                                                                                   
          Dollars Submitted to Paypal                                                                                        
   Dollars Submitted by cheque made payable to QEMA and forwarded to     
                                      Dan Rainey 
                                           87 Barley Road,
                                                           Belleville  ON  K8N 4Z1
                                 CA           



Remember to left Click Submit Button
                                Registration Fee $45.00 per person (CAD)   


      
                  Link to pay SLATE Conference Fee Online using PayPal        

Your Questions?Comments


Link to the SLATE Conference Page