Course Registration Form

*Your Name:  Organization or Affiliation:
*Street or P.O. Box #:  *City: *Province: *Postal Code:
*Email Address:  *Phone #:

*I agree to have my name and contact information included on a participants’ list that will be available only at the conference. The Columbia Mountains Institute does not share or sell conference participant lists. See our Privacy Policy.

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*A $50.00 (+ HST) cancellation fee applies if you cancel your registration on or before May 11, 2012. From May 12 onward, sorry, no refunds unless we can fill your space from a wait list. The cancellation fee will be retained from your refund if we fill the space.

If the course is cancelled the Columbia Mountains Institute is not responsible for any costs other than a full refund of the registration fee.

I have read and agreed to the cancellation policy (please check the box to the right):

You may wish to review our complete Policy for Registration and Cancellation.

*required fields

Payment

Your course registration is not secured until we have received payment for your course fee.
Course Registration Fee
$675.00
HST Tax at 12%:
Total:

   

The CMI uses the services of PayPal's secure payment centre and does not see your credit card information.

**Tips for paying with a credit card

  • You don't need to have a PayPal account to pay your registration fee. When you are sent to the PayPal web site, please choose the PayPal link that says "Don't have a PayPal account?" or "Pay with a credit card".
  • If you are having trouble using a corporate credit card, check that your address, etc., on the PayPal page matches the corporate information related to your card. (The information on the PayPal page auto-completes to match your registration form, so change it if you need to.)

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Columbia Mountains Institute of Applied Ecology
Box 2568 Revelstoke, B.C. V0E 2S0
Tel: 250-837-9311 Fax: 250-837-9311
Email: