Register for CLCCO 2023

Please contact HayMatick at 778-882-4389 or info@haymatick.com for any questions regarding registration.

PLEASE NOTE: ONLY INDUSTRY THAT ARE SPONSORING THE CONFERENCE MAY REGISTER.
CONFERENCE IS NOT OPEN TO NON SPONSORING INDUSTRY

REGISTRANT INFORMATION:
(* = required field)

* Dr. Mr. Mrs. Ms.

*First Name

*Last Name

*Institution/Hospital/
Clinic

*Address

*City

*State/Province

*Zip/Postal

*Country

*Telephone

*Email

*Specialty

*Are you a Fellow/Resident?

YES NO

*If you have SPECIAL DIETARY NEEDS,
please indicate your requirements

ACCOMMODATION:

The Canadian Lung Cancer Conference 2022 has negotiated a discounted room rate of $259/night + taxes. Please book your room at the link below while rooms are still available.

To book your accommodation directly with Fairmont Pacific Rim Hotel click here (new window).

Or you can also call 604-695-5350, toll-free at 1-877-900-5350 and ask for reservations. Please be sure to identify yourself as part of the Canadian Lung Cancer Group

*Would you like to be notified of other upcoming education events?		YES NO
PLEASE RSVP:
*Will you be attending the Canadian Lung Cancer Conference Opening dinner taking place on Thursday February 2nd at the Fairmont Pacific Rim?		YES NO
*Will you be attending the Canadian Lung Cancer Closing Dinner taking place on Friday February 3rd at Riley's Fish and Steak?		YES NO

REGISTRATION FEES:

Early Bird Registration until January 5th, 2023:
Physician registration $300
Allied Health Prof., Residents and Fellows registration $200

After January 5th, 2023
Physician registration $400
Allied Health Prof., Residents and Fellows registration $250

Registration fees collected by HayMatick on behalf of Canadian Lung Cancer Conference

PAYMENT INFORMATION:

PAYMENT BY Credit Card (VISA, MasterCard or American Express):
We are using SSL (Secured Socket Layer) encryption technology to protect your credit card information during transmission

Credit Card:	VISA MasterCard American Express
Credit Card Number:
Your credit card number must not contain spaces.
Expiry Date:
CVD (3-4 digit code)
Cardholder Name:
Payment Amount:	$300

PAYMENT BY CHEQUE:
PLEASE MAKE CHEQUE PAYABLE TO "HayMatick Meetings & Events"
PAYMENT BY CHEQUE CAN BE MAILED IN ADVANCE TO:

HayMatick Meetings & Events
#202-5525 West Boulevard
Vancouver, BC V6M 3W6

Refunds, full or partial, will not be issued within 14 business days of conference.