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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.

REGISTRANT INFORMATION:
(* = required field)

*
*Last Name
 
*First 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:
Rosewood Hotel Georgia, Vancouver

FIRVA 2017 has negotiated a discounted room rate of $329/night at the Rosewood Hotel Georgia. Please book your room at the link below while rooms are still available.

To book your accommodation directly with the Rosewood Hotel Georgia click here.

Alternatively, guests can call / e-mail the hotel directly and reference that they are attending the FIRVA conference. 604-682-5566 or Georgia.reservations@rosewoodhotels.com

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

FIRVA shares a FIRVA participant list with Silver to Platinum sponsors that includes the participant's name, specialty and city. 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 September 28th at the Rosewood Hotel Georgia?
 

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 August 28th, 2017:
     Early Bird Registration fee is $350
     Early Bird Registration with submission/presentation of case: $300

After August 28th, 2017:
     General Registration fee is $450
     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: $350

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.