Primary Contact

== Mr. Mrs. Ms. Dr.
First Name*:		Last Name*:
Address*:
City*:		Province/State*:
Country*:		Postal Code*:
E-Mail Address*:
Phone Number*:	() -
* compulsory field
I will bring    0 1 2 3    guests.** ** Please call ORBIS Canada at 416-413-7925 or toll-free at 1-877-672-4722 if you would like to bring more than three guests.
General Public Tours (Approximately 45 minutes in length) I/We would like to register for the General Public Tour on the following date and time and I will donate $20 per person to ORBIS Canada (one tax receipt will be mailed to the primary contact's name and address after the event). I understand that no cancellations or refunds will be permitted.     ================ November 17, 2011 (Thursday) 2:15 pm November 17, 2011 (Thursday) 3:00 pm November 17, 2011 (Thursday) 3:45 pm November 18, 2011 (Friday) 10:00 am November 18, 2011 (Friday) 10:45 am November 18, 2011 (Friday) 11:30 am November 18, 2011 (Friday) 12:15 pm November 18, 2011 (Friday) 1:00 pm November 18, 2011 (Friday) 1:45 pm November 19, 2011 (Saturday) 12:15 pm November 19, 2011 (Saturday) 1:00 pm November 19, 2011 (Saturday) 1:45 pm November 19, 2011 (Saturday) 2:30 pm November 19, 2011 (Saturday) 3:15 pm
Grand Reception (Business Attire) I/We would like to attend the Grand Reception on Friday, November 18, 2011 (6 pm to 9 pm) and I will pay $50 admission per person (no tax receipt will be issued). I understand that no cancellations or refunds will be permitted.
Other I would like to donate an additional amount of $
Credit Card Information
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Expiry Date: (MM/YY)	/
Please note that it may take a few minutes for your registration to process. Do NOT click the "Submit" button more than once or this could result in duplicate submissions. Once submitted, you should receive an e-mail confirmation within a few minutes. If you do not receive any confirmation, please contact infocanada@orbis.org.
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