Deliberative Dialogue 2019 – Registration

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Please RVSP by October 23, 2019 to ensure your spot.

Registration for this meeting is limited and is only available to those who have been invited. If you are unable to attend but would like to have someone else from your organization attend on your behalf, please contact Madeline Gallard: [email protected]

General Application Information

Information collected via this application form is confidential and will be used solely for the purposes of determining attendance, evaluation purposes and for post-event follow up by the event sponsors.
By completing and submitting the information requested in this online application form, I am acknowledging that I have read, understood and accept the travel and accommodation guidelines, the cancellation and no-show policy and the expense reimbursement guidelines provided in the emailed invitation. I also agree to complete the post event evaluations.(Required)
Name(Required)

Travel and Accommodations

Please note that travel and accommodation reimbursement are only available to those living outside of the Lower Mainland. For those who receive travel subsidies, please note that in the case of air travel, the BASE PRICE of a flight will be covered, but any additional charges are the responsibility of the individual or their organization. This includes, but isn't limited to, baggage costs, changes to reservations, and other fees. Please answer the following questions:
If you are applying for travel reimbursement, PAN will need to approve travel plans in writing before they are made. Please make sure your flights are booked before November 6, 2019. Are you applying for travel reimbursement? (Flight, ferry, mileage, etc)(Required)
Are you applying for a hotel reimbursement?(Required)

General Application Hotel Reservation Information

Please complete the information below to streamline the registration process. PAN will book hotel stays for for the night of November 20. Please Note: A credit card or cash deposit will be required upon check-in for incidentals/damage deposit. If you do not have a credit card or are not able to pay a cash deposit, please let us know below in the "special requirements" section.

Media Release Information

We will be asking all conference participants to sign a media release form at the onsite registration desk asking for permission to use videos and/or images from the conference for our website, promotional material and reporting purposes. Please indicate below if you will NOT be signing the form so that we can have a name tag that indicates that you do not consent to have your photo taken.
Do you wish to have a special nametag to indicate that you DO NOT want your photo taken or used?(Required)
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Please WAIT to be taken to the Pacific AIDS Network home page after you press SUBMIT button. If you don't wait, your registration will not go through.

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