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PROCESS & AUTOMATION SHOWS

Please fill in all * mandatory fields of the form, check your data entry, and click on Submit Registration button.


First Name*   Last Name*  
Job Title*   Email*  
Phone* ()  Fax () 
Company*  
Address*   Addr. (Cont.)  
City*   Prov/State*    
Postal/Zip*  

1. Choose the show(s) you are registering for:
 
 Sarnia, ON (April 28, 2010) - Dante Club
Halifax, NS (May 18, 2010) - Casino Nova Scotia
St. John's, NL (May 20, 2010) - Delta St. John's
Regina, SK (September 9, 2010) - Delta Regina
Mississauga, ON (September 29, 2010) - Mississauga Convention Centre
Calgary, AB (October 27, 2010) - Coast Plaza Hotel
Nepean, ON (November 16, 2010) - Nepean Sportsplex
Boucherville, QC (November 18, 2010) - Hotel Mortagne

2. Yes! I Want To Receive (Or Continue To Receive) A FREE Subscription To
    Canadian Process Equipment & Control News. *
 
Yes
No

3. Which of the following best describes your organization? *
 
Industry group:  

Specific Industry:
If other, please specify:

4. FOR AUDIT PURPOSES ONLY *
  In lieu of a signature, please answer the following question.

What is the first letter of the month in which you were born?


Thank you for completing your Registration!