Healthcare Conferences Canada Inc.

5th Educational Conference on Palliative & End of Life Care
Caring for Persons with Terminal Illness:
Living with the Dying in Multicultural Canada

Friday, April 23, 2010
Toronto Don Valley Hotels & Suites
1250 Eglinton Avenue East, Toronto, Ontario

REGISTRATION FORM
(Register by mail, online, email, fax or phone)

To pay by credit card, complete the Registration Form and click the submit button.
Last Name:
First Name:
Address:
Street:
Suite#:
City:
Province:
Postal Code :
Institution/ Hospital Affiliation (optional):
Telephone	(e.g. 4161112222)
Fax:
Email:

Registration Fee:

	Regular - $ 145. 00
	Seniors (60+) & Students - $ 125. 00

Registration Deadline: April 16, 2010
Registration fee after the deadline - $ 145.00 for all
(Registration Fee includes Conference package, taxes, breakfast, hot-lunch & refreshment breaks)

Credit card payments accepted online, otherwise by cheque/ bank drafts payable to:
Healthcare Conferences Canada Inc.

Mail your you registration forms & cheques to:
Calista Anne Mervis
Conference Coordinator -HCCI
10, Pinemore Crescent
Toronto, ON, M3A 1W6