MNL REGIONAL MEETINGS - Registration Form 2016

Please complete the registration form below. If you have any questions please contact the MNL office via telephone: 709-753-6820 or email: info@municipalnl.ca

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* 1. Please indicate which regional meeting you wish to attend.

Avalon: February 19-20

Central: February 26-27

Eastern: March 18-19

Northern: April 1-2

Western: April 8-9

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* 2. Municipality / Organization Name

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* 3. What is your phone number?

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* 4. What is your e-mail address?

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* 5. What is your mailing address?

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* 6. Cost of each registration is $125. HST is not required.
Refund Policy: Requests for refunds must be received at the MNL office three days prior to the meeting date.

Yes, I have read and understand the refund policy.

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* 7. Please list the individuals you wish to register.

Name #1

Position with Council

Name #2

Position with Council

Name #3

Position with Council

Name #4

Position with Council

Name #5

Position with Council

Name #6

Position with Council

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* 8. Please indicate your payment option.

Visa/Mastercard

Please Invoice

Email Transfer: rpiercey@municipalnl.ca

Other (please specify)

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* 9. If using Visa or MasterCard, please indicate the following:

Visa or Mastercard number

Name as it appears on card

Expiry date

Address of card holder including postal code

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* 1. Please indicate which regional meeting you wish to attend.

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* 2. Municipality / Organization Name

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* 3. What is your phone number?

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* 4. What is your e-mail address?

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* 5. What is your mailing address?

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* 6. Cost of each registration is $125. HST is not required.Refund Policy: Requests for refunds must be received at the MNL office three days prior to the meeting date.

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* 7. Please list the individuals you wish to register.

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* 8. Please indicate your payment option.

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* 9. If using Visa or MasterCard, please indicate the following:

* 6. Cost of each registration is $125. HST is not required.
Refund Policy: Requests for refunds must be received at the MNL office three days prior to the meeting date.