Vancouver Island Conference Centre
Nanaimo, BC




If you have problems using this form or questions about registration, please contact ProReg Registration Solutions by phone, at 866-760-2005, or by e-mail, at viea@ProReg.ca.

For all other enquires, please contact George Hanson at George@viea.ca

The asterisk (*) indicates a required field.
DELEGATE INFORMATION
*First name :
*Surname :
Member Company :

Select your company name in the dropdown list below to register as a VIEA member.


Non-member Company : If you are not a member, please enter your company name in the space below and consider becoming a member (Scroll down on this page.) for registration discounts.
*Position :
*Mailing address :
 
*City :
*Province/territory/state :
*Postal code/zip code:
*Country :
*Telephone :  Ext #:
*E-mail :
Company Website : http://
Twitter :
Check this box if you do not wish to have your contact information posted in the online listing of attendees. Click here to see the current list.
 

Help us with our statistics:

Gender : Male Female

Age Group: 18 - 30 31 - 45 45 - 65 65+

This is our eleventh summit. How many have you attended?

 

Dietary restrictions :

Please indicate any food allergies (i.e. seafood, nut)
Please indicate dietary requirements (i.e. vegetarian); be as specific as possible

Special needs :

Comments (include any special consideration about your registration) :


 


REGISTRATION
IF YOU REGISTER MORE THAN ONE PERSON FROM YOUR ORGANIZATION NOW, SAVE $20 ON EACH ADDITIONAL REGISTRATION.
  Registration
    Before
August 1
August 1
October 17
After
October 18
Registered Delegate ~ Member $369 $399 $499
Registered Delegate ~ Non-Member $419 $449 $499
Summit Speaker ~ Full Summit $269
Summit Speaker ~ Wednesday
Included, if only attending day of presentation
Summit Speaker ~ Thursday Included, if only attending day of presentation
Sponsor Included, requires approval by Summit Staff
Media Included, requires approval by Summit Staff
Exhibitor Included, requires approval by Summit Staff

Enjoy Member Benefits NOW

Join the Vancouver Island Economic Alliance and save on your registration. Simply select the member option above and choose the appropriate member category below.

IF YOU REGISTER MORE THAN ONE PERSON FROM YOUR ORGANIZATION NOW, SAVE $20 ON EACH ADDITIONAL REGISTRATION.

For large Corporations (500 plus employees) and large communities with populations over 10,000 ~ Membership fee $1,000 annually
 
For medium sized businesses (50-499 employees), small communities under 10,000 population ~ Membership fee $500 annually
 
For small sized businesses (employees -2-50) ~ Membership fee $250 annually
 
For Micro sized business/home based business ~ Membership fee $150 annually
 
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PAYMENT SUMMARY
Sub-Total :
GST :
Total Registration Fee :

By Credit Card : VISA MasterCard American Express Cheque or Money Order
(Please note: Your credit card statement will say that payment was made to ProReg, Nanaimo, BC)

Name of cardholder :
Credit card number :
Expiry date :
/
CVV:
3 or 4 digit number on back of card
Please ensure credit card expiry date is correct. Use of the mouse scroll wheel may alter selected information.


Cancellation & refund policy is outlined below.

Rest assured, your personal data is secure (opens a new window)

Additional invoices
If you require your invoice/receipt to be sent to an additional contact, for accounting purposes, please enter the information below.

Name :
E-mail :
Fax :
 

EMERGENCY CONTACT INFORMATION
In the event of an emergency, whom should we contact?
Name :
Phone :
E-mail :

CANCELLATION POLICY


Registration fees are refundable, less a $50 administrative fee, if notification is received in writing no later than September 30th, 2017. No refunds will be made after this date.


 

Submission of this form constitutes acceptance of the conditions of this policy.

Please note that professional photos will be taken throughout the event which may or may not used by VIEA in future promotions. By attending this event you are giving implicit permission to VIEA to use photos that may include your image in print and electronic marketing materials.

Please check this box If you do not wish your image to be used.

 


  Press 'Submit' to complete your registration.
 

If you have problems using this form or questions about registration, please contact ProReg Registration Solutions by phone, at 866-760-2005, or by e-mail, at viea@ProReg.ca.

For all other enquires, please contact George Hanson at George@viea.ca