Registration: PAN/IH Interior Regional Training November 21-22, 2017 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. I also agree to complete the post event evaluations (one at the end of the training itself and a follow-up survey 3-6 months following the event). Information collected via this application form is confidential and will be used solely for the purpose of determining attendance, evaluation purposes and for post-event follow up by the event sponsors.Name(Required) First Last Email(Required) Organization(Required) Job Title City(Required) Phone(Required)General Registration InformationDo you require a travel subsidy to attend this event?(Required) Yes* No *For those requiring a travel subsidy you will be contacted with further information.Do you have any food allergies? Please detail below: Hotel Accommodation and Reservation InformationShared hotel accommodation is available at no charge for people who reside outside of Kelowna. We can also accommodate requests for private rooms at a fee of $60/night (you will be invoiced in advance of the event start date). Please note that a credit card or cash deposit will be required upon check-in for incidentals/damage deposit. PAN will cover one day of hotel per each day of the event (i.e. up to 2 days of hotel).If you reside outside of the city of Kelowna and require hotel accommodation, please complete the information below. I would like a: Single Room ($60/night charge) Shared room (no cost) If sharing please indicate who you would like to share with: What day will you be arriving at the hotel: MM slash DD slash YYYY What day will you be departing the hotel: MM slash DD slash YYYY Do you have any special hotel requirements (i.e. Wheelchair accessible): Photo ReleaseWe will be asking event participants to sign photo release forms at the onsite registration desk asking for permission to use images from the event for our website, promotional material and reporting purposes. Please indicate below if you will NOT be signing the waiver 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) YES, I want a special nametag, I DO NOT want my photo taken NO, I intend to sign the release form PhoneThis field is for validation purposes and should be left unchanged. Δ