REGISTRATION FORM The Toronto Police Service Psychological Services Canadian by selfesteem

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									                               REGISTRATION FORM

                  The Toronto Police Service – Psychological Services
                           Canadian Police Psychology Forum
        Working with Police Special Teams: Understanding the Psychologist’s Role
                                 September 25-26, 2008
                                   Holiday Inn on King
                            370 King Street West Toronto, ON


Please complete the following form and submit it either by fax or mail to the
contact information at the end of the Registration Form. You will receive
confirmation of registration via E-mail within 5 business days.


___________________________________________________________________________
NAME


___________________________________________________________________________
TITLE

___________________________________________________________________________
ORGANIZATION

___________________________________________________________________________
ADDRESS

___________________________________________________________________________
CITY                             PROV. /STATE             POSTAL CODE/ZIP CODE

___________________________________________________________________________
TELEPHONE                                          FAX

___________________________________________________________________________
E-MAIL
ACCOMMODATION

Please indicate if you will require a room at the conference hotel, Holiday Inn on King:
   YES       NO

Room Rate: $189.00 CDN Single/Double Occupancy for standard room. You are responsible to
make your own hotel reservations. To receive this rate, delegates must identify the group code
‘P08FF’ when making the reservations. The “cut-off date” for accepting reservations into this room
block is August 25, 2008.

                Telephone: 416-599-4000;               Toll Free: 1.800.263.6364



WELCOME DINNER

I will be attending the dinner                  Will you be bringing a guest?      YES        NO


I will not be attending the dinner

Please Choose One Dinner Entrée:

   Grilled Tenderloin of Beef        Chicken Supreme filled with Spinach and Garlic           Vegetarian

Please indicate any special dietary needs or restrictions:

___________________________________________________________________________

___________________________________________________________________________


PAYMENT

EARLY REGISTRATION (including GST):                                             $183.75
For registration prior to August 1, 2008

LATE REGISTRATION (including GST):                                              $210.00
For registration after August 1, 2008

TPS MEMBERS (including GST):                                                    $168.00
Special rate until September 1, 2008

ADDITIONAL DINNER TICKETS
____________ at $75.00 each (tax and gratuity included)                         $ _________
Special price until September 1, 2008


                                                              TOTAL COST:       $ _________
PAYMENT (Continued)

    Cheque                                   Money Order
(P a y a b l e t o “ T o r o n t o P o l i c e S e r v i c e ” )


Credit Card:             Visa                MasterCard [No other credit card will be accepted]

__________________________________________                         _________________________________
Card Number                                                        Expiry Date

___________________________________________________________________________________
Name as it appears on credit card

___________________________________________________________________________________
Signature

Please note: Full payment by cheque or credit card is required within 10 days of registration. Please
make cheques payable to “Toronto Police Service”.


Cancellation Policy
Full refund, less a $10.00 administration fee, will be given for cancellations received in our office by
September 1, 2008. All cancellations must be received by this date. Cancellations after this date will
not be eligible for refund or credit.

A registrant who is unable to attend may send a substitute. Please inform us beforehand at
Donna.Scantlebury@torontopolice.on.ca.

GST # 867402299RT0001



                           PLEASE DO NOT SUBMIT DUPLICATE REGISTRATIONS.
                       Payment by cheque or registration by mail may be forwarded to:
                                         Ms. Donna Scantlebury
                                       c/o Toronto Police Service
                                             40 College Street
                                                 Room 2C
                                        Toronto, Ontario M5G 2J3
                                                 Canada

                    Fax registrations to the attention of Donna Scantlebury at 416.808.7172

								
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