| Registration Form | |
| for Members of the
ASCnet local chapters |
| ASCnet member $275.00 | ASC user group: | ||
| Non-member $350.00 |
| Brokerage: | |
| Address: | |
| Address: | |
| City: | |
| Province: | |
| Postal Code: | |
| Phone Number: | ###-###-#### |
| Contact : | |
| Email: | |
| TAM version: |
| Participant's Name: | Position: | Amount | |
| Total |
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Please make cheques payable to: TASCnet Please mail cheques to:
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NOTE: If you receive an error and cannot complete the registration form on-line, please print a copy and fax to 416-754-3914. We will confirm your registration by return email. |