AIRWORTHINESS
Airworthiness Symposium & Trade Show
symposium & trade show The Coast Plaza Hotel & Conference Centre—Calgary, Alberta CANADA 1-800-663-1144 or (403)-248-8888 ————————————————————MARCH 16 - 18, 2016
MINI-COURSE REGISTRATION FORM
PLEASE PRINT CLEARLY - ONE FORM PER PERSON Last Name
Name
Initial
City
Prov/State
PC/Zip
Phone (Residence)
Phone (Business)
Fax
Company Name (for name tag) Address
Email
Western AME Membership Number
MINI-COURSE REGISTRATION OPTIONS Space is limited! Be sure to register early. No Refunds. Mini-Course
Course Date/Time
Human Factors Workshop, System Safety Services (1 Day Course) Max. 30
March 16/16, 8:30 - 16:00
Selection
Cost
Total
$250.00 + GST
Add GST @ 5% (GST #868942988) TOTAL ENCLOSED Payable to the Western AME Association—No Refunds
* You must be an Update 2016 registrant who is a new or renewing Western AME Association member to register for these courses. Please complete the Update 2016 registration form and the Western AME Association application/renewal form, in addition to this form. Payment for mini-course(s), Western AME Association Membership and Update 2016 symposium must be paid in full before your seat can be reserved. Payment Option #1: Register online at www.wamea.com Payment Option #2 Payment Option #3 Payment by cheque ______ Send to: WAMEA P.O. Box 21101, Edmonton, AB T6R 2V4 Bus: (780)-462-1173 Fax: (780-413-0076
[email protected] - www.wamea.com
Payment by ____ OR ____ Card #______________________________________________ Name on card: _______________________________________ Signature:___________________________ CSV#___________ Expiry Date: ______________________ Fax to: 780-413-0076
