Credit Card Pre-Registration - Edmonton

Please use this form to register for CCNA being held in Edmonton, AB, Canada. This form uses Credit Card for payment. The is a small fee built into the processing to cover processing charges.

If you prefer to pay for your registration by Email Money Transfer, please click here

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Have you previously made a purchase from CCNA XXXII and now making additional purchases?

Have you previously made a purchase from CCNA XXXII and now making additional purchases? No, I have not registered Yes, I have previously registered
Registrants Information

Complete this section with information of the registrant. All packages purchased will be under the one name used below.
Name Name First Last
Though this is an anonymous program, your full name would be very helpful in processing your registration
Address Address
Street Address City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email

Be sure to use an accurate and valid email address as this is where your registration confirmation will be sent
Want to share your clean date for our clean time count down? Want to share your clean date for our clean time count down? / DD / MM YYYY

This will help us as we prepare for the clean time countdown
Would you be interested in attending French speaking meetings?

Would you be interested in attending French speaking meetings? Yes No
Are you interested in serving?

Are you interested in serving? Speaker (minimum 3 years) Chair Person (minimum 2 years) Sub Committee (clean time requirement will be determined based on activity)
Pre-Registration(s)

Select the type and input the quantity of items you require.

The Full Registration Package includes 1 Basic Registration, 1 Comedy Ticket, 1 Friday Night Event Ticket, 1 Saturday Night Banquet Ticket, 1 Saturday Night Dance Ticket and 1 Sunday Brunch Ticket
Pre-Registration Full

Pre-Registration Full Pre-Registration Full Package ($187.20)
Pre-Registration Full Package Quantity

How many Full Registrations would you like to purchase?
Pre-Registration Basic

Pre-Registration Basic Pre-Registrations Basic Package ($41.60)
Pre-Registrations Basic Package Quantity

How many Basic Registrations do you wish to purchase?
Comedy Show

Comedy Show Comedy Show ($20.80)
Comedy Show Quantity

How many Comedy Tickets do you wish to purchase?
Saturday Night Dance

Saturday Night Dance Saturday Night Dance($15.60)
Saturday Night Dance Quantity

How many Dance Tickets do you wish to purchase?
Banquet Dinner

Banquet Dinner Saturday Night Dinner ($72.80)
Saturday Night Dinner Quantity

How many tickets to the Saturday Night Dinner would you like to purchase?
Sunday Brunch

Sunday Brunch Sunday Brunch ($36.40)
Sunday Brunch Quantity

How many tickets to the Sunday Brunch would you like to purchase?
Food Options

Select the type and quantity of meals you require based on your previous meal purchases. One meal selection for every meal purchased.
Regular Meal

Regular Meal Regular Meal
Quantity Regular Meals
Vegetarian

Vegetarian Vegetarian
Quantity of Vegetarian Meals
Select Meal Type Vegan

Select Meal Type Vegan Vegan Type Meal
Quantity of Vegan Meals
Select Meal Type Gluten Free

Select Meal Type Gluten Free Gluten Free Type Meal
Quantity of Gluten Free Meals
Additional Add On's
Complete Downloadable Speaker Package From CCNA XXXII available after the close of the Edmonton convention. Check the box and add quantity

Complete Downloadable Speaker Package From CCNA XXXII available after the close of the Edmonton convention. Check the box and add quantity $31.20 - Discounted Complete Speaker Recording Package
Quantity of Full Recording Packages

Click the box to purchase and add the quantity of downloads requested
New Comer Contribution $ Dollars . Cents
Monies collected through this process are used to assist those who cannot afford a registration package. $30.00 buys a basic reg package
It is agreed and understood that all sales are final. There will be NO refunds. However, requests by the authorized purchaser to transfer Registration Package(s) to another person may be completed upon approval of the CCNA Local Work Group (LWG)

It is agreed and understood that all sales are final. There will be NO refunds. However, requests by the authorized purchaser to transfer Registration Package(s) to another person may be completed upon approval of the CCNA Local Work Group (LWG) Yes, I agree
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Credit Card Pre-Registration - Edmonton

Credit Card Pre-Registration - Edmonton

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Registrants Information

Pre-Registration(s)

Food Options

Additional Add On's

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Credit Card Pre-Registration - Edmonton

Credit Card Pre-Registration - Edmonton

C$0

Total

Registrants Information

Pre-Registration(s)

Food Options

Additional Add On's

C$0

Total

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C$`0`