Page 1 of 2
Delegate Registration Form
Online registration
www.cpma.ca
90th Annual Convention and Trade Show
April 15-17, 2015 – Montréal, QC, Canada
It’s quick and easy!
Telephone: (+1) 613-226-4187 • Fax: (+1) 613-226-2984 • [email protected]
Full delegates will have access to all business and social events including meal functions, as well as access
to the trade show. More information on the event can be found at www.cpma.ca.
STEP 1 · Delegate Information
Receive reduced registration
prices when you register
on or before
February 20, 2015.
Please type or print clearly – one person or couple per form.
Your name and company will appear on your badge exactly as you indicate below. Where space is limited, abbreviations may be used (i.e. company name).
Mr
Mrs
Language of correspondence:
Ms
First Name
English
French
Last Name
Title
Company
Street Address
City
Prov./State
Telephone
Postal/Zip Code
Country
Ext.
Cellular
Email (email is required to receive electronic confirmation)
Website
Please indicate if you have any food allergies/restrictions?
In case of an emergency, please contact:
Yes
No
Specify:
Name
Relation
Telephone
STEP 2 · Company Business Type Please check one.
1.
Retailer
4.
Grower/Shipper
7.
Processor
2.
Wholesaler
5.
Broker
8.
Media
3.
Foodservice Operator/Distributor
6.
Industry Supplier
9.
Service Provider
10.
Importer/Exporter
STEP 3 · Spouse/Companion Program Please type or print clearly.
Complete this section ONLY if you are registering for the spouse/companion program. See registration fees on next page. A spouse/
companion registration must be accompanied by a Full delegate registration and is intended for the delegate’s spouse or significant other
only and not for additional corporate registration.
Mr
Mrs
Ms
First Name
Last Name
Email
Please indicate if you have any food allergies/restrictions?
In case of an emergency, please contact:
Name
Yes
No Specify: Relation
Telephone
Delegate Registration Form
Page 2 of 2
STEP 4 · Registration Fees
HST/GST #106846587 RT0001
Please check appropriate boxes
All delegates - excluding Quebec residents
QST #1015654194
CPMA MEMBER
Base
5% GST
NON-MEMBER
Total

Base
5% GST
Total

Early Bird - BY February 20, 2015
Qty
Business Delegate
$900.00
$45.00
$945.00
$1,250.00
$62.50
$1,312.50
Companion/Spouse
$525.00
$26.25
$551.25
$700.00
$35.00
$735.00
$50.00
$2.50
$52.50
$150.00
$7.50
$157.50
$1,075.00
$53.75
$1,128.75
$1,450.00
$72.50
$1,522.50
$625.00
$31.25
$656.25
$800.00
$40.00
$840.00
$50.00
$2.50
$52.50
$150.00
$7.50
$157.50
Retail Tour
Total
Regular - AFTER February 20, 2015
Business Delegate
Companion/Spouse
Retail Tour
GRAND TOTAL
Delegates - Quebec residents
CPMA MEMBER
Base
9.975%
QST
5% GST
NON-MEMBER
Total

Base
5% GST
9.975%
QST
Total

Early Bird - BY February 20, 2015
Qty
Business Delegate
$900.00
$45.00
$89.78
$1,034.78
$1,250.00
$62.50
$124.69
$1,437.19
Companion/Spouse
$525.00
$26.25
$52.37
$603.62
$700.00
$35.00
$69.83
$804.83
$50.00
$2.50
$4.99
$57.49
$150.00
$7.50
$14.96
$172.46
$1,075.00
$53.75
$107.23
$1,235.98
$1,450.00
$72.50
$144.64
$1,667.14
$625.00
$31.25
$62.34
$718.59
$800.00
$40.00
$79.80
$919.80
$50.00
$2.50
$4.99
$57.49
$150.00
$7.50
$14.96
Retail Tour
Total
Regular - AFTER February 20, 2015
Business Delegate
Companion/Spouse
Retail Tour
$172.46
GRAND TOTAL
STEP 5 · Method of Payment Please type or print clearly – no invoices will be issued.
Pay by cheque or credit card.
Visa
American Express
MasterCard
Cheque enclosed (Make cheque payable to: Canadian Produce Marketing Association)
Credit Card Number
CVV (3 or 4 digit code on back of credit card)
Expiry
Date
m
m
Cardholder’s Name
Signature
Note: Credit card information provided here is for registration fee payment only.
Date
Cancellation Policy: All requests for cancellation must be in writing. There is a $150.00 processing fee per registrant for
cancellations received on or before February 27, 2015. No refunds will be issued after February 27, 2015.
STEP 6 · Send in Your Registration
Fax or email all pages (credit card payment only) to: (+1) 613-226-2984 or [email protected]
Or mail (with payment) to:
Canadian Produce Marketing Association
162 Cleopatra Drive, Ottawa, Ontario, Canada K2G 5X2
Privacy Policy:
By completing this form you consent to the use of the personal information
you provided for registration and marketing purposes. For more information
regarding CPMA’s Privacy Policy, please visit our website at www.cpma.ca
For CPMA Use Only
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Page 1 of 2
Partial Registration Form
Canadian Produce Marketing Association • 90th Annual Convention and Trade Show
April 15-17, 2015 – Montréal, QC, Canada
Telephone: (+1) 613-226-4187 • Fax: (+1) 613-226-2984 • [email protected]
Online registration • www.cpma.ca • It’s quick and easy!
STEP 1 · Delegate Information
Please type or print clearly – one person or couple per form.
Your
name and company will appear on your badge exactly as you indicate below. Where space is limited, abbreviations
may be used (i.e. company name).
Mr
Mrs
Language of correspondence:
Ms
First Name
English
French
Last Name
Title
Company
Street Address
City
Prov./State Postal/Zip Code
Telephone
Ext.
Country
Cellular
Email (email is required to receive electronic confirmation)
Website
Please indicate if you have any food allergies/restrictions?
Yes
Specify:
No
In case of an emergency, please contact:
Name
Relation
Telephone
STEP 2 · Company Business Type Please check one.
1.
Retailer
6.
Industry Supplier
2.
Wholesaler
7.
Processor
3.
Foodservice Operator/Distributor
8.
Media
4.
Grower/Shipper
9.
Service Provider
5.
Broker
10.
Importer/Exporter
Partial Registration Form
Page 2 of 2
STEP 3 · Registration Fees
HST/GST #106846587 RT0001
Please check appropriate boxes
All delegates - excluding Quebec residents
QST #1015654194
CPMA MEMBER
Base
5% GST

NON-MEMBER
Total
Base
5% GST
Total

Wednesday April 15, 2015
Qty
$50.00
$2.50
$52.50
$150.00
$7.50
$157.50
$150.00
$7.50
$157.50
$180.00
$9.00
$189.00
Day Pass*
$410.00
$20.50
$430.50
$495.00
$24.75
$519.75
After Party
$25.00
$1.25
$26.25
$35.00
$1.75
$36.75
Banquet Ticket (Single ticket)
$180.00
$9.00
$189.00
$225.00
$11.25
$235.25
Banquet Table (Table of 10)
$1,620.00
$81.00
$1.701.00
$2,025.00
$101.25
$2,126.25
$10.00
$210.00
$200.00
$10.00
$210.00
Retail Tour
Welcome Reception
Total
Thursday April 16, 2015
Friday April 17, 2015
Thursday April 16 & Friday April 17, 2015
Trade Show only
$200.00
GRAND TOTAL
Delegates - Quebec residents
CPMA MEMBER
Base
5% GST
9.975%
QST
NON-MEMBER

Total
Base
5% GST
9.975%
QST

Total
Wednesday April 15, 2015
Retail Tour
Qty
$50.00
$2.50
$4.99
$57.49
$150.00
$7.50
$14.96
$172.46
$150.00
$7.50
$14.96
$172.46
$180.00
$9.00
$17.96
$206.96
Day Pass*
$410.00
$20.50
$40.90
$471.40
$495.00
$24.75
$49.38
$569.13
After Party
$25.00
$1.25
$2.49
$28.74
$35.00
$1.75
$3.49
$40.24
Welcome Reception
Total
Thursday April 16, 2015
Friday April 17, 2015
$180.00
$9.00
$17.96
$206.96
$225.00
$11.25
$22.44
$258.69
Banquet Table (Table of 10) $1,620.00
Banquet Ticket (Single ticket)
$81.00
$161.60
$1,862.60
$2,025.00
$101.25
$201.99
$2,328.24
$19.95
$229.95
$200.00
$10.00
$19.95
$229.95
Thursday April 16 & Friday April 17, 2015
Trade Show only
$200.00
$10.00
GRAND TOTAL
*Thursday Day Pass: Includes Delegate & Companion Breakfast, Business Sessions, Delegates Lunch, Trade Show & After Party.
STEP 4 · Method of Payment Please type or print clearly – no invoices will be issued.
Pay by cheque or credit card.
Visa
American Express
MasterCard
Cheque enclosed (Make cheque payable to: Canadian Produce Marketing Association)
Credit Card Number
CVV (3 or 4 digit code on back of credit card)
Expiry
Date
m
m
Cardholder’s Name
Signature
Note: Credit card information provided here is for registration fee payment only.
Date
Cancellation Policy: No refunds.
STEP 5 · Send in Your Registration
Fax or email all pages (credit card payment only) to: (+1) 613-226-2984 or [email protected]
Or mail (with payment) to:
Canadian Produce Marketing Association
162 Cleopatra Drive, Ottawa, Ontario, Canada K2G 5X2
Privacy Policy:
By completing this form you consent to the use of the personal information
you provided for registration and marketing purposes. For more information
regarding CPMA’s Privacy Policy, please visit our website at www.cpma.ca
For CPMA Use Only
y
y