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Education Conference Attendee Information Form

Please note, this form was due by Wednesday, March 31. If you have not filled out the form yet and are a confirmed attendee to this year's event, please fill out this form as soon as possible.

Complete every field and double check that all information is correct. You can find your member number on the envelope of your last mailed PEA-communication or on your membership card (this field is optional). Please do not hit enter prior to the form being completed as it will submit the form.

Once the form is submitted, you will receive a confirmation email from the PEA. Should you have any questions or concerns regarding this form, please contact our Lower Mainland office at 604.581.6662 (from the Metro Vancouver area) or toll-free at 800.323.0488 (from anywhere in BC).

The information collected from this form will be used solely for Conference planning purposes and will not be dispensed to any third party individuals or organizations.

Membership Information

Name:

Member Number (optional):

Email address:

Phone Number:

Chapter:

Mailing

Street Address

 

City

Province Postal Code

Attendance Information

 

I will require hours of union leave on May 13(Thursday)
I will require hours of union leave on May 14 (Friday)

I require accommodation for the nights of May 13 May 14 May 15

I will be bringing a guest to dinner on May 14
Note that the dinner is complimentary for guests. Guests are responsible for all other costs incurred.


Dining concerns for you and/or your guest (e.g. allergies, religious requirements, vegetarian etc.)

 

Accessbility concerns for you and/or your guest (e.g. airborn allergies, wheelchair access etc.)

Other concerns for you and/or your guest

 

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