Fall Conference Registration Form

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2016 CCVA Fall Conference Registration

* Indicates required field

Name *

First

Last

Clinic Name *

Email *

Are you a current 2016 CCVA member? *

Yes - individual Yes - part of a clinic membership No Don't know

Are you a: *

Veterinarian Industry Rep Other

Please select which options you would like to attend: *

Full Conference – Includes Thursday and Friday Lectures, Gourmet dinner with wine tasting and Friday lunch Thursday Seminar Small Animal Thursday Seminar Large Animal Gourmet Autumn Dinner with Wine Tasting Friday Seminar Small Animal – Includes Lunch Friday Seminar Large Animal – Includes Lunch Friday Lunch Only

Please indicate how many ADDITIONAL tickets you would like to purchase for the Autumn Dinner with wine tasting: (EXCLUDING any ticket purchased above with a full conefrence option) *

Any additional comments or food allergies: *

*A confirmation e-mail will be sent to you with the total amount due and Details for to make your payment online or By Cheque.

Submit

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Links Page
Help