2024 CSN AGM Event Registration - Corporation

CORPORATION REGISTRATION

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PASSCODE*

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Registration Information

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Registration Type

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Member Type

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CSN Member ID

Are you a member of CKD-N?*

What best describes you?*

Please enter your info for "Other"*

Title*

Your Name*

Company*

Registrant's Email Address*

(Note: If you are filling out this form on behalf of another attendee, please enter the attendee's email address.)

Phone*

Gender*

Affiliation*

(If you do not have an affiliation, enter "None")

Organization*

(If you are not part of a company/organization, enter "None")

Are you a Community Nephrologist?*

Please select your level of training*

Are you actively conducting research?*

Please describe your research category*

Biomedical Research

Bioethics

Knowledge Translation

Translational / Valley 1

Clinical Research

Other

Please enter your info for "Other" research category*

Your Lab Director's Name*

Your Lab Director's Email*

Confirm your HCP standing*

By registering, I am confirming I am a healthcare professional in good standing

Pre-Course

Pre-Course (FREE attendance for Trainees)

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Will you be attending the Pre-Course on May 1st & 2nd?*

If you are attending the Pre-Course, you must arrive in Montreal no later than the evening of Tuesday, April 30th.

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Will you be attending the Pre-Course on May 1st & 2nd?*

PLEASE NOTE

- For CSN Members who are not Trainees, Pre-Course attendance fee is $400.
- For Non Members, fee is $600.
- For Non Member PhD's, fee is $300.
- A valid passcode will waive the Pre-Course fee.

If you are attending the Pre-Course, you must arrive in Montreal no later than the evening of Tuesday, April 30th.

Gala Dinner

Dinner Preferences

Will you be attending the CANA Summit Reception/Dinner on Wednesday, May 1st at 5:00 p.m. EDT (Dinner is included in registration)*

Are you attending the AGM Gala Dinner on May 4th*

PLEASE NOTE: Gala Dinner fee is $200 without a valid exemption passcode.

Name of person attending the dinner*

Select meal preference*

Select Yes or No if have food allergies*

Please indicate food allergies*

Join The Walking Challenge!

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Would you like to participate in the Walking Challenge? All funds collected from the Walking Challenge go fully to KRESCENT.*

PLEASE NOTE: Walking Challenge contribution is $50. No taxes are charged on your Walking Challenge contribution.

Billing Address

Billing Address*

Order Summary & Payment

2024 CSN AGM Registration: MD*

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2024 CSN AGM Registration: MD*

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2024 CSN AGM Registration: MD-CAPN*

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2024 CSN AGM Registration: MD-CAPN*

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2024 CSN AGM Registration: Non-MD with PhD*

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2024 CSN AGM Registration: Non-MD with PhD*

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2024 CSN AGM Registration: Non-Member PhD*

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2024 CSN AGM Registration: Associate Trainee*

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2024 CSN AGM Registration: Associate Non-MD Research Trainee*

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2024 CSN AGM Registration: Associate Allied Health Group*

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2024 CSN AGM Registration: Associate Allied Health Group*

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2024 CSN AGM Registration: Associate Corresponding*

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2024 CSN AGM Registration: Associate Corresponding*

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2024 CSN AGM Registration: Associate Non-Nephrologist*

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2024 CSN AGM Registration: Associate Non-Nephrologist*

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2024 CSN AGM Registration: Associate Meritorious*

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2024 CSN AGM Registration: Associate Meritorious*

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2024 CSN AGM Registration: Associate Honorary*

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2024 CSN AGM Registration: Corporation*

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2024 CSN AGM Registration: Non-Member*

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2024 CSN AGM Registration: Corporate Partner (Complimentary)*

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2024 CSN AGM Registration: Exhibitor (Complimentary)*

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2024 CSN AGM Registration: Guest (Complimentary)*

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2024 CSN AGM Registration: Speaker or Moderator (Complimentary)*

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2024 CSN AGM Registration: Staff (Complimentary)*

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Pre-Course Attendance Fee*

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Pre-Course Attendance Fee (Non-Member)*

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Pre-Course Attendance Fee (Non-Member PhD)*

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Pre-Course Attendance (Complimentary)*

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Pre-Course Attendance (Trainee)*

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Gala Dinner*

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Gala Dinner*

Price:

Gala Dinner (Complimentary)*

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Gala Dinner (Complimentary)*

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2024 CANA Summit Registration*

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2024 CANA Summit Registration: Speaker*

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2024 CANA Summit Registration: Moderator*

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2024 CANA Summit Registration: Staff*

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2024 CANA Summit Registration: Guest*

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Walking Challenge Contribution*

Price:

Subtotal

$ 0.00 CAD

Tax (Quebec 14.975%)

$ 0.00 CAD

Total

Payment Information*

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Please review the accuracy of all information above prior to proceeding.

Only click the Register button ONCE and do not refresh or close this page while the registration is being processed.

Registration may take up to 30 seconds to process.

CORPORATION REGISTRATION

Registration Information

Pre-Course

Pre-Course (FREE attendance for Trainees)

Gala Dinner

Dinner Preferences

Join The Walking Challenge!

Billing Address

Order Summary & Payment

Please review the accuracy of all information above prior to proceeding.Only click the Register button ONCE and do not refresh or close this page while the registration is being processed.Registration may take up to 30 seconds to process.

Please review the accuracy of all information above prior to proceeding.

Only click the Register button ONCE and do not refresh or close this page while the registration is being processed.

Registration may take up to 30 seconds to process.