2017 UNSM Conference Registration Form
  1. Westin Nova Scotian Hotel
    Halifax Regional Municipality, NS
    November 7-10, 2017

    Registration Fees

    Delegate (before October 17, 2017): $523.25 (includes HST) + $5.00 Carbon Offset Fee
    Late Delegate (after October 17, 2017): $580.75 (includes HST) + $5.00 Carbon Offset Fee
    Non-Member Delegate (before October 17, 2017): $580.75 (includes HST) + $5.00 Carbon Offset Fee
    Non-Member Delegate (after October 17, 2017): $638.25 (includes HST) + $5.00 Carbon Offset Fee

  2. Municipality(*)
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  3. Name of Contact Name(*)
    Please type your full name.
  4. Title of Contact Person:(*)
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  5. Telephone Number
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  6. E-mail(*)
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  7. VOTING DELEGATES: All Elected Officials are eligible to vote.
  8. 1. Mayor / Warden / Councillor(*)
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    If your Mayor/Warden isn't attending you can put "Councillor and their Name" on this line to complete the On-Line Registration.
  9. 2. Deputy Mayor / Deputy Warden / Councillor
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  10. 3. Councillor
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  11. 4. Councillor
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  12. 5. Councillor
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  13. 6. Councillor
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  14. 7. Councillor
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  15. 8. Councillor
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  16. 9. Councillor
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  17. 10. Councillor
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  18. 11. Councillor
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  19. 12. Councillor
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  20. 13. Councillor
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  21. 14. Councillor
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  22. 15. Councillor
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  23. 16. Councillor
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  24. 17. Councillor
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  25. 18. Councillor
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  26. NON-VOTING STAFF DELEGATES:
  27. 1. CAO / C/T / Town Manager
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  28. 2. Deputy CAO / Deputy Clerk/Treasurer
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  29. Other
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  30. Other
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  31. Other
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  32. Other
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  33. Other
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  34. Other
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  35. Please list those who would like extra banquet Tickets

    PLEASE NOTE: An Extra Banquet Ticket costs $74.75

    (*)
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  36. Please list those who would be participating in the Town Hall Tour

    The Tour is at maximum capacity (40) and new participants will be on a waiting list
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  37. Please list those who would be participating in Yoga

    PLEASE NOTE: Yoga costs $5.75

    LIMITED TO FIRST 12 REGISTRANTS
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  38. Please provide details of dietary restrictions(*)
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  39.