Please fill in a separate entry form for each member of your family/group attending the Convention.
Please contact the Convention committee for details of discounted family registration fees.

CONVENTION REGISTRATION FORM
(23rd July, 2008 - 27th July, 2008)

Registration Type

Regular ($249) Late Entry($299) 23rd July ($100) 24th July ($100)
25th July ($100) 26th July ($100) 27th July ($100)

Applicant Information

Title Mr. Mrs. Ms. Dr. Rev.
Name: _______________________________________________________________
(Last)                                              (First)                                          (Middle Initial)

Complete Mailing Address:

(Street) _______________________________________________________________ 

(City)                                         (Province) ________(Postal Code) _________________

(Country) _____________________________________________________________

Telephone Numbers:    Work: ___________________ Home:_____________________

E-Mail Address: ________________________________________________________

Spousal Information (Applicable to Family Registration)

Name: _____________________________________________________

Dependent(s) Information (Applicable to Family Registration)

Name: ___________________________ Relationship:________________

Name: ___________________________ Relationship:________________

Name: ___________________________ Relationship:________________

Signature: _________________________ Date:_____________________

CONVENTION SECTION/TOPICS/SUBJECT INTERESTED IN:

__________________________________________________________

Please complete this form, print and mail it with your registration amount to:

GNAT
18 Geraldton Crescent
(Finch and Leslie St)
Toronto, ON
M2J 2R6.

PLEASE MAKE YOUR CHEQUE OR MONEY ORDER PAYABLE TO GNAT