Seminar Registration

Policies

Payment will be accepted in Canadian funds by cheque, money order, Visa, Mastercard or Amex. Credit card payments must be completed in full, signed and faxed to 416-596-9532. All cancellations or transfer requests must be in writing and will be subject to an administration fee. Any cancellations received less than five (5) days before the day of the event will be subject to all registration fees.

Registration is a three-step process:

• Fill out this form and click 'Register Me Now!'
• Review the information you've submitted, then click 'Confirm'
• Print your registration receipt and payment form, then mail/fax your payment.

All fees must be received prior to attending events. To complete your registration, please mail registration fees payable to the Canadian Health Care Anti-fraud Association to:

Ms. Jacinta Khan
CHCAA
386 Huron Street
Toronto, Ontario M5S 2G6

Registration Form

Registration Details
I am a CHCAA member.
This registration is GST exempt*.
GST Exemption # (*if GST exempt):
I am a speaker at this event.
I am a vendor/sponsor at this event.
I would like a certificate for this event.
Personal Information
Title:	-- Ms. Dr. Mr. Mrs.
First Name (Required):
Last Name (Required):
Name for Badge, If Different:
Contact Information
Address Type:	Home Office
Street Address:
City:
Province:
Postal Code:
Country:
Tel:
Fax:
E-mail (Required):
Organization Information
Organization Name:
Organization Type:	-- Public payer Private payer Federal government agency Provincial government agency Law enforcement Health profession association Health profession regulator Third party administrator *Other
Organization Type (*if Other):
Special Requests and Requirements
Special meal(s) requested (specify):
Other Information
Preparer Name:
Preparer Phone Number:
How did you hear about this event?	Please select Email from CHCAA Email from professional association CHCAA web site Received a faxed event notice Other web sites (specify web site) Other (please specify)
If Other, Please Specify:
How would you prefer to hear about future events?	Please select Email from CHCAA Email from professional association Receive a faxed event notice Receive a printed notice in the mail Other (please specify)
If Other, Please Specify:
Confirm Event(s) You Wish To Attend (Hold down the CTRL key while clicking to select multiple events)
Current Seminars
May 28, 2009 - Panel: A Multi-Perspective Approach to Orthotics

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