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2011 AGM and GCN Forum Registration Form

May 3-6, 2011 — Montreal, Quebec

Please complete this online form:

Name:

Organization:

Address:

City:

Province:

Postal Code:

Phone Number:

Fax Number: (optional)

E-mail:

Project Code: (if applicable)

Affiliations:University
  
  
  

 Government

 Industry

 Other (Specify)

Students & post-doctoral fellows, indicate supervisor name(s):

 

Dietary Restrictions (if any):

I will be attending Dinner (May 4th, 2011)              

I will be attending the banquet (May 5th, 2011)    

 

Registration: Spaces are limited.
We will confirm registration via e-mail.

Registration Fees

Before April 18th, 2011 After April 18th, 2011
Member* FREE

 $50
Student FREE

 $50
Non Member

 $200

 $250

* Green Crop Network affiliated researchers, post-doctoral fellows and graduate students.

Payment of Registration Fees

By Cheque

To pay by cheque please print this form, write down your contact information and send it with your cheque. Cheques are to be made payable to "Green Crop Network" and sent to:

Green Crop Network
Department of Plant Science
Macdonald Campus, McGill University
Department of Plant Science
21,111 Lakeshore Rd
Ste-Anne-de-Bellevue
Quebec H9X 3V9
Canada

By Credit Card

Please print and fill out this form, and sign the appropriate section. Subsequently, please fax (514) 398-7897 (Attention to Green Crop Network) or mail us a signed copy of this form.