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MOBILE PAYMENTS WORKSHOP
April 2, 2015, Toronto

GROUP REGISTRATION $1495.00 Plus HST

ACT CANADA MEMBER GROUP RATE $1295.00 plus HST
A maximum of 4 delegates is allowed under group registration.

If you wish to register more than 4 people, please send an email request to steve@paymentsbusiness.ca. Each additional delegate beyond 4 is $295 each plus HST.

Please use this form below

1. Complete the information for each delegate.
2. Complete the company or organization information.
3. Indicate your method of payment. All fees must be paid prior to the event.
3. Press "submit". We'll take care of the rest.
4. You will receive confirmation of your registration and a receipt for payment.
5. Prior to the seminar, you will receive information about the location, agenda, etc, by email. Questions? Send an email to steve@paymentsbusiness.ca or call 1-800-668-1838 x 225
.


GROUP REGISTRATION

Please complete carefully and include payment details.

DELEGATE 1
First Name Last Name

Title

Email
 
 
DELEGATE 2
First Name Last Name

Title

Email
 
 
DELEGATE 3
First Name Last Name

Title

Email
 
 
DELEGATE 4
First Name Last Name

Title

Email
 
 

COMPANY DETAILS

 
Company  

Address 1

 

 

Address 2

 

 

City

Province/State

 

 

Postal Code/Zip

 

 

Phone

Fax

 

 

Email
 
 
Yes, we are members of ACT Canada (please check if your company is a member)
 

FEES: Team of Four Registrations: $1495.00 or $1295.00 for ACT Canada Members
Each additional registration above 4: $295.00

 
 

PAYMENT DETAILS

INCLUDE ALL INFORMATION. Please note to include the billing address associated with the credit card.

 
CREDIT CARD DETAILS Card Number Exp Date (as XX/XX). CVN Number (3 or 4 digits)
NAME ON CARD:
Billing Address (if different from address on registration):
 

Bill me      Purchase Order Number Invoices must be paid upon receipt.

 

I'm mailing a cheque with my registration.

Make cheque out to Lloydmedia, Inc.

and mail to:

302-137 Main Street North

 

Markham, ON L3P 1Y2

 
 
 

 

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All material © Lloydmedia, Inc.
302-137 Main Street North
Markham, ON L3P 1Y2
905-201-6600 / 1-800-668-1838