Registration Form - Newmarket Chamber of Commerce

1. Contact Information
(please print clearly or type) Chamber Member Non-Member
Last Name: First Name: Middle Name:
(as it appears on passport)
Company Name:
Address:
City: Province: Postal Code:
Phone: Fax: E-Mail:
Date of Birth (MM/DD/YYYY):
Nationality:
Passport Number: Passport Exp. Date: Country Issued By:
2. Travel Information
I will be rooming with - full name(s):
Bed Request(s): Two Doubles King-Size Roll-Away Bed
Please upgrade my airfare to Business Class for an additional $6000
Please provide me with a single room for the entire trip for an additional $500
Please list the additional people you will be traveling with (for bus seating):
3. Payment Information: Trip Cost is $2,199 USD per person (additional $200 for non-members)
A non-refundable deposit of $200 USD per person is due with each registration. The balance and all additional fees are due on
or before December 15 th , 2011
US cheques, bank drafts and cash all in US Dollars are acceptable.
Cheques made payable to: Travel Professionals International
Cancellations must be submitted in writing by December 15 th , 2011. Cancellations after December 15 th , 2011 forfeit all
payments.
All required documents must be submitted by December 15 th , 2011. No changes to travel accommodations or travel group are
accepted after December 15 th , 2011.
Name:
Signature:
Date:

4. Payment Total 5. Payment Method
Chamber Member Subtotal: $ USD US Cheque attached (payable to Travel Professionals International)
Non-Member Subtotal: $ USD Cash (US Dollars)
Bank Draft/Money Order (payable to Travel Professionals International)
Less Deposit w/booking: $ USD
Balance Remaining: $ USD
Travel Partner
Newmarket Chamber of Commerce
470 Davis Drive Newmarket, ON L3Y 2P3
T: 905-898-5900 F: 905-853-7271
E: info@newmarketchamber.ca
www.newmarketchamber.ca
Naqi Ahsan, CTC
Direct Line: 905-853-5146 E: nahsan@tpi.ca
4 Robert Speck Parkway, 15 th Floor,
Mississauga, ON L4Z 1S1 P: 905-896-6948
www.acrewtpi.ca
ON Registration 1576226