Lecor Travel Services1-800-965-3267

Register for an Event

Please use this form to register over the internet. If you prefer to register by phone, or if you have any questions, please contact us.

Your Contact Information

Name
Courier Address
City
Province/State
Postal/ZIP Code
Business Phone
E-Mail
Cell Phone

Administrative Assistant Contact

Name
Phone
E-Mail

Travel Information

Travel required?
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

Hotel

Hotel required?
Arrival Date D: M: Y:
Departure Date D: M: Y:
Room Type
Special Requests
(incl. roommate)

Personal

Allergies
Dietary Restrictions

Emergency Contact

Name
Relationship
Day Phone
Evening Phone

Comments

Comments