Exhibitor RegistrationFNHMA 2019 National Conference Fairmont Queen Elizabeth Hotel Tuesday, November 5 to Thursday, November 7, 2019 1. Exhibitor InformationBase Price Price: $ 0.00 CAD Quantity: Name* First Name: Last Name: Title:Organization:Division:Email:* Phone:*Address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country 2. Booth Space FeesWith the purchase of a booth space, each exhibitor receives one (1) complimentary conference pass and one (1) pass for an individual to staff the booth (please provide names below). ALL other individuals from your organization who wish to attend the conference must register as conference delegates (please complete a participant registration form).Fees*Booth Space - $ 1,375.00 CADArtisans - $500 CADIs your First Nation, Community or organization GST exempt?*NoYesNote: The conference is being held in Quebec where 5% GST applies.The FNHMA HST/GST number is 811344852. If your Indian band is GST/HST exempt, please upload a copy of the band’s exemption certificate or letter by clicking “choose file” button to find and upload your certification or letter in digital form (only .JPG, .PNG, .PDF accepted). Note: an individual’s personal status card is not an accepted document for tax exemption for the conference.Certificate or letter File Upload*Accepted file types: jpg, jpeg, png, pdf.Please confirm the names of individuals using the 2 passes:*One full conference pass: First Last TitleEmail *One staff at the booth: First Last TitleEmail Important: If you would like to purchase lunch and/or dinner tickets for the person staffing your booth, please complete the “exhibitor staff” registration form available on the exhibitors' page on the conference web site.3. PaymentPlease Choose Your Payment Method*Pay by Credit CardPay by ChequeSubtotal $ 0.00 CAD Add 5% GST $ 0.00 CAD Total $ 0.00 CAD Credit Card* American ExpressMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name 4. CancellationCANCELLATION*Cancellation of your exhibitor registration should be sent in writing by email to firstname.lastname@example.org. Cancellations will be accepted until Friday, October 4, 2019 for a full refund. A 50% cancellation fee will apply for cancellations received between October 5 and 11, 2019. No refund for cancellations received after October 11, 2019 and no refund for no-shows at the conference. I agree to the Cancellation Policy. Confirmation ID Number This iframe contains the logic required to handle AJAX powered Gravity Forms.