NLMA Forms
AGM Registration Form

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Instructions Use this form to register for the AGM Business Session and/or President's Dinner.

Registrant (NLMA Members ONLY)

Name

NLMA Number

Badge Name

Badge Title

Diet/Allergies

Registrant (Non-NLMA Members ONLY)

Name

Organization

Job Title

E-mail

Badge Name

Badge Title

Diet/Allergies

Registration

Registration*
(Check all that apply)

Business Session
President's Dinner (Registrant)
President's Dinner (Guest)

Guest (President's Dinner)

Name

Diet/Allergies

Notes

Requests/Questions


(*required)

Policies
Deadline Registration for the President's Dinner closes 5 pm, Thursday, May 24.
Cancellations
Cancellations received 48 hours before the event
will receive a full refund.


Assistance For assistance, please contact Anna Delaney, Communications Coordinator at (709) 726-7424 (314), (800) 563-2003 (314) or adelaney@nlma.nl.ca.

Newfoundland and Labrador Medical Association
NLMA House, 164 MacDonald Dr., St. John's, NL, Canada, A1A 4B3
Telephone (709) 726-7424 | Toll Free (800) 563-2003 | Fax (709) 726-7525
E-mail nlma@nlma.nl.ca | Web www.nlma.nl.ca