PIC's Innovation Conference Nov 14-15, 2023

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With Event Executive Sponsors

Company / Organization Name*

Name*

First Name

Last Name

Email Address*

Confirm Email Address *

Phone*

Fee*

Member ($200.00 CAD) Non-member ($245.00 CAD) Banquet Only ($50.00 CAD) Admin /sponsor only no fee ($0.00)

Short Answer

Additional Attendees

Number of additional attendees

You may add a maximum of 4

Company / Farm Name 1*

Name 1*

First Name

Last Name

Email Address - Additional attendee 1*

Confirm Email Address *

Guest 1 Fee*

Member ($200.00 CAD) Non-member ($245.00 CAD) Banquet Only ($50.00 CAD)

Company / Farm Name 2*

Name 2*

First Name

Last Name

Email Address - Additional attendee 2 *

Confirm Email Address *

Guest 2 Fee*

Member ($200.00 CAD) Non-member ($245.00 CAD) Banquet Only ($50.00 CAD)

Company / Farm Name 3*

Name 3*

First Name

Last Name

Email Address - Additional attendee 3*

Confirm Email Address *

Guest 3 Fee*

Member ($200.00 CAD) Non-member ($245.00 CAD) Banquet Only ($50.00 CAD)

Company / Farm Name 4*

Name 4*

First Name

Last Name

Email Address - Additional attendee 4*

Confirm Email Address *

Guest 4 Fee*

Member ($200.00 CAD) Non-member ($245.00 CAD) Banquet Only ($50.00 CAD)

Total Registration Fees CA$

Sponsorship Opportunities Still Available

Event Level Sponsor $1,000.00 - see website for details

I would like to be a Sponsor at (CAD $1,000.00)

Executive Sponsor $2,500.00 - see website for details

I would like to be a Sponsor at (CAD $2,500.00)

Total Sponsorship Amount

Payment

Total Payment CA$

Payment Type*

Pay by Credit Card Pay by Cheque

Quantity

Address

Address Line 1

Address Line 2

City

Province

Postal Code

Please send cheque to:

Poultry Industry Council
483 Arkell Road
Puslinch, Ontario
N0B 2J0

Thank you to current Event Sponsors: