Register IBAS 2019 Registration Form PER If you are human, leave this field blank. 1: ENTER COMPANY INFORMATION Company Name: * Company Street Address: City/Province: Postal Code: Contact Email Address: Contact Phone Number: 2: CHOOSE EITHER OF THE FOLLOWING Status: Member Industry Partner 3: ENTER NAMES OF ATTENDEES Participant’s Full Name: * Registration Type (Member): FULL PARTIAL Registration Type (Industry Partner): FULL PARTIAL Partial Member Registration Thursday Lunch AGM Trade show Friday Breakfast Friday Education Sessions Friday Awards Luncheon & Keynote Friday Chair's Reception & Banquet Partial Industry Partner Registration Thursday Lunch Trade show Friday Breakfast Friday Education Sessions Friday Awards Luncheon & Keynote Friday Chair's Reception & Banquet Registration Notes (Include Dietary Restrictions, etc.): *PLEASE INCLUDE THE NAME OF THE INDIVIDUAL TO WHOM THESE NOTES APPLY. ADD ANOTHER PARTICIPANT REMOVE THIS PARTICIPANT 4: PAYMENT Total: GST: Payment Options * Credit Card Cheque ***When Credit Card is selected, you will be securely redirected to the PayPal site to complete your registration payment. Registration is not complete until payment is complete. Please complete the online registration, click submit and finish by mailing the cheque to IBAS at 305 – 2631 28th Ave Regina, SK S4S 6X3. Grand Total: reCAPTCHA REGISTER NOW Presenting Partners COPYRIGHT 2019 INSURANCE BROKERS ASSOCIATION OF SASKATCHEWAN. ALL RIGHTS RESERVED. SITE BY ADSPARK COMMUNICATIONS.