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MPWWA 2012 TRADE SHOW REGISTRATION


 Delta Prince Edward Hotel - Charlottetown, PEI
April 23rd, 2012
COMPANY INFORMATION
Company Name*
Street*
PO Box*
City*
Province*
Postal Code*

PERSONAL INFORMATION
Name*
Work Phone*
Cellular Phone
Fax
e-mail*
Registration Type*
Membership Type*
Membership Number*

NAME TAG INFORMATION
Booth Worker #1
Booth Worker #2
Booth Worker #3

ADDITIONAL MEALS
Tuesday AGM Breakfast
Tuesday Evening Banquet
Wednesday "Stay to the End" Luncheon


TOTAL PAYMENT DUE