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First Name(*)
Please type your first name.
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Last Name(*)
Please type your last name.
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Gender(*)
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E-mail(*)
Invalid email address.
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PTSBC Membership Number
Do you have your PTSBC membership number?
If you don't have your membership number at the time of registration, simply input "pending" so you don't miss out on registering for this great event!
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Month and Year of registration with Provincial Regulatory College
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Employment Organization(*)
Please enter the name of the organization you work with.
Who do you work for? Name of the hospital or retail / community pharmacy.
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Job Title / Role(*)
Please enter your current position with the organization.
Your primary role / title. This will appear on your name badge.
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Employment Sector(*)
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Registration Fees
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For Catering Purposes(*)
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For catering purposes, please select one of the three options
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Dietary Restrictions(*)
Any dietary restrictions we should be aware of?
For catering purposes, please select one of the these options.
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Dietary Information
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Please specify the severity of the allergy/restrictions i.e is it anaphylactic, airborne, religious reasons, etc.
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Accommodation Type
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If booking own accommodations the PTSBC group regular rate is $169.00 for 1 King bed or 2 Queen - standard room. 1 Bedroom Resort Suite rate is $209.00. PTSBC encourages you to book through the PTSBC registration form. Non PTSBC group rate is $232.00.To get accommodation special rate, must register by Sept 1st.
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Room Guest Name
Any special requests?
Please provide name of any guests who will be sharing the room with you so they can be added to the rooming list.
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Name of Payee
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Please identify whose name the payment will be processed under. (Name on credit card).
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Select Payment Method
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Total
0.00 CAD
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