Register form

Please fill out this form to complete your registration for our Conference & Recognition Evening.

Please note that the AQCAMO is not a registered charity. Therefore, we cannot send you a donation receipt for income tax purposes. All donations will be sent to The Leukemia & Lymphoma Society of Canada. AQCAMO will not retain any amount or profit from these donations.

The AQCAMO will be responsible for collecting donations, counting the amounts received and forwarding them by cheque to The Leukemia & Lymphoma Society of Canada. It will be responsible for sending a complete list of the names of donors whose information sharing agreement we have received.

Make a donation
Please indicate your preferred email address to which you want to receive the details of your registration and your receipt.
Delivery Address
Delivery Address
City
Province
Postal Code
Country
I will be present for : 
Choice of meal : (Saturday dinner) :
I will be accompanied

You must register your guest separately. To do so, click here.

Meal rates:

  • For Oncology Drug Access Members and Coordinators, or all professionals involved: Free

Guest:

  • Friday meal: $50 plus taxes
  • Saturday meal (4 courses): $70 plus taxes

*Participation in the conference and the Soirée Reconnaissance is free. However, this year, the AQCAMO has taken the initiative to offer participants the possibility of making a donation in exchange for their participation. The amount of the donation is at your discretion. Please note that the AQCAMO is not a registered charity. Therefore, we cannot send you a donation receipt for income tax purposes. All donations will be sent to The Leukemia & Lymphoma Society of Canada. AQCAMO will not retain any amount or profit from these donations.

Choice of donation amounts
I agree that AQCAMO may share my name and email address with The Leukemia & Lymphoma Society of Canada so that they may send me a donation receipt
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