Registration Form

Canadian Institute of Public Health Inspectors
74th Annual Educational Conference
July 20-23, 2008
Delta St. John’s Hotel and Conference Centre
St. John’s, Newfoundland and Labrador, Canada

For printable PDF version of this form, please click here

Conference Delegate Information

Delegate's Name:

Method of Payment
Credit Card Payment:
Visa	Mastercard	AMEX
Card #:
Expiry Date: (mm/yy) /
Name on Card:
Written requests for cancellation must be received by May 1, 2008 by the Conference Chair through the mail or fax to receive a full refund (less 20% processing fee). No refunds will be given following this date. Substitutions (alternates) are permitted up to and including the first day of the conference. Note: Credit card charges will appear as McCarthy’s Party on your credit card statement.

Check here if you wish to have your name included in the published list of conference delegates.

Title/Position

Organization

Address

City

Province

Postal Code

Phone

Fax

Name on Delegate Tag (First Name Only):

Special Dietary/Mobility Requirements

Registration Fees (CDN Funds)	CIPHI / NEHA***	Non – Member	Please Select Registration Type
Early Bird Full Registration* ( By May 31, 2008)	$499	$599
Full Registration (After May 31, 2008)	$569	$669
Daily Registration**	$150 / day	$175 / day
Student/Retired Member Full Registration	$250	$300
Student/Retired Daily Registration	$75 / day	$90 / day

Social Events (cost for additional tickets) – golf is not included in full registration Please check the box next to the social events you wish to register for.			# of Tickets
	18 Hole Golf Tournament (Sunday, July 20, 2008) – not included in registration	$75
	Welcome Reception (Sunday, July 20, 2008)	$25
	Network Luncheon (Monday, July 21, 2008)	$35
	Rally in the Alley (Monday, July 21, 2008)	$70
	President’s Banquet (Tuesday, July 22, 2008)	$75
	Awards Luncheon (Wednesday, July 23, 2008)	$40

Companion/Spouse Activities: Please visit www.mccarthysparty.com to view and book a variety of exciting tours and sightseeing opportunities in the St. John’s area.

*Full registration includes the following: Welcome Reception, Network Luncheon, Rally in the Alley, President’s Banquet and Awards Luncheon.

**Daily registration includes that day’s nutrition breaks and lunch (Tuesday lunch is on your own). Evening social events are not included.

***NEHA membership registration benefits apply to United States residents only.

Accommodation: Rooms are available at the Delta St. John’s Hotel and Conference Centre. Please visit www.deltastjohns.com/ciphi to book your room. The block of rooms available to delegates at reduced conference rates will be held until June 1, 2008.

Additional Information: Please contact Darryl Johnson at 709.729.3422 or djohnson@gov.nl.ca, or Terry Battcock at 709.729.2104 or tbattcoc@gov.nl.ca for additional information.