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Register

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

FIRVA is an interactive forum that will promote open discussion and audience participation. Please join the dialogue by bringing a case to share.

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

REGISTRANT INFORMATION:
(* = required field)

*
*First Name
 
*Last Name
*Address
 
*Hospital/Clinic/Company Name
*City
 
*State/Province
*Zip/Postal
 
*Country
*Telephone
 
Fax Number
*Email
  *Category
*Are you an Allied Health Professional?
(nurse, radiology tech., administrator)
   
*Are you a Fellow/Resident?    

ACCOMMODATION:
Delta Hotels Vancouver Downtown Suites

FIRVA 2019 has negotiated a discounted room rate of $299/night at Delta Hotels Vancouver Downtown Suites. Please book your room at the link below while rooms are still available.

To book your accommodation directly with Delta Hotels Vancouver Downtown Suites click here.

Comments / Questions
ADDITIONAL INFORMATION:
*If you have SPECIAL DIETARY NEEDS,
please indicate your requirements
 

FIRVA 2019 shares a participant list with Diamond, Gold and Silver sponsors that includes all contact information. Please check the box below if you DO NOT wish to have your information included on this participant list:

PLEASE RSVP:

*Will you be attending the FIRVA Welcome Reception on Thursday October 17th at the Wosk Centre for Dialogue?
 

REGISTRATION FEES:

Submit and prepare a case for presentation and you will receive a $50 reduction on your registration fee!
(10 minutes allotted for case presentation)

Early Bird Registration until September 17th, 2019:
     Early Bird Registration fee is $400
     Early Bird Registration with submission/presentation of case: $350

After September 17th, 2019:
     General Registration fee is $475
     General Registration with submission/presentation of case: $400

Fellows, Residents, Radiology Technicians, Nurses, Administrators:
Registration Fee is $175

*I will submit and prepare a case for presentation(s) and reduce my registration fee
 

Registration fees collected by HayMatick on behalf of FIRVA

PAYMENT INFORMATION:

We are using SSL (Secured Socket Layer) encryption technology to protect your credit card information during transmission.
Credit Card:
   
Credit Card Number:
Expiry Date:
CVD
(3-4 digit code)
Cardholder Name:
Payment Amount: $475

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

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

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