Registration Form - Groupe Export agroalimentaire
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Ticket Reservation Tuesday May 2, 2017 – 5pm Allstream Center - Connected to Enecare Centre 105 Princes' Boulevard – Toronto Presented by: TICKET RESERVATION Please reserve _______ ticket(s) at $250 each + 32,50$ (13% TVH ONTARIO) = 282,50$ $ PARTICIPANT NAME AND ADDRESS (Please see Payment method on following page) Name: Company: Address: City: Prov.: Postal code: Country: Tel.: Email: Notes: You will be receiving your badge from our welcoming committee the evening of the Event To speed registration, please provide the names of all participants (next page) Please select your category below (only one choice) Acheteurs / Buyers Ingrédients & additifs / Food Ingredients Aliments pour animaux / Pet Food Mets préparés / Prepared meals Aliments santé/Health Food Produits de boulangerie / Bakery Products Association Produits de la mer / Seafood Products Boissons / Beverages Produits laitiers / Dairy Products Condiments Produits surgelés / Frozen Products Produits sucrés / Sweet products Professionnel / Professional Conserves / Canned Products Service financiers / Finances Fruits et Légumes / Fruits and Vegetables Soupes et sauces / Soups and sauces Gouvernement / Government Viandes / Meat Grains et céréales / Grains and Cereals Other: PAYMENT METHOD □ Credit card □ VISA □ MasterCard □ AMEX Card #: Exp.: Signature: □ Cheque payable to Agri-Food Export Group (Members only) IMPORTANT To reserve, complete this form and send it by email to Véronique Folny E-mail: [email protected] - Phone. 418-456-7854 Additional participant Additional participant Name: __________________________________________ Name: __________________________________________ E-mail:__________________________________________ E-mail:__________________________________________ Company : ______________________________________ Company : ______________________________________ Category : _______________________________________ Category : _______________________________________ Additional participant Additional participant Name: __________________________________________ Name: __________________________________________ E-mail:__________________________________________ E-mail:__________________________________________ Company : ______________________________________ Company : ______________________________________ Category : _______________________________________ Category : ______________________________________ Additional participant Additional participant Name: __________________________________________ Name: __________________________________________ E-mail:__________________________________________ E-mail:__________________________________________ Company : ______________________________________ Company : ______________________________________ Category : _______________________________________ Category : _______________________________________ Name: __________________________________________ During : E-mail:__________________________________________ Company : ______________________________________ Category : _______________________________________
