Event Registration Form

Please use this form to register via the web, or contact us.

Your Contact Information
Name
Courier Address
City
Province/State
Postal/ZIP Code
Business Phone
E-Mail
Cell Phone
Alternate Contact (Administrative Assistant)
Name
Phone
E-Mail
Travel Information
Do you require travel arrangements? Air Rail None
City of Origin
Arrival Date D: M: Y:
Preferred Arrival Time
Departure Date D: M: Y:
Preferred Departure Time
Seating Preference
Frequent Flyer No.
Preferred Carrier
Special Requests
Conference Transfers
Transfers Required None
Arrival (Airport to Hotel)
Departure (Hotel to Airport)
Both
Hotel
Do you require hotel accomodations? Yes No
Arrival Date D: M: Y:
Departure Date D: M: Y:
Room Type Smoking Non-Smoking
Roommate Requests Yes No
Special Requests
Personal
Allergies
Dietary Restrictions
Emergency Contact
Name
Relationship
Day Phone
Evening Phone
Comments
Comments
Lecor Travel Inc. - 50 Burnhamthorpe Road West, Suite 302 - Mississauga, Ontario, Canada - L5B 3C2
Tel: (905) 275-0212 - Fax: (905) 275-2592 - Toll-Free: 1-800-965-3267 - info@lecortravel.com