* indicates required fields

• Preferred Salutation:*
• Dr. Prof. Ms. Mrs. Mr.
• First Name:*
• Last Name:*
• Position/Title:*
• Mailing Address:*
• Department:
• Room:
• Institution Name:*
• Email:*
• Work Phone:*
• Extension:
• Dietary Restrictions:
• May we publish your name and contact information on an attendees list?*
• Yes No
• The Agenda follows a large-group format, except for the following roundtable sessions. Please select your preferred roundtable session from the list below:*
• Clinical Trials Ontario Scope of REB responsibility/accountability Proportionate approach to research ethics review Variability in REB approval determinations Pedagogy vs. Classroom Research REB management of privacy legislation compliance Issues pertaining to genetic research
• Registration Fee (per person) 95.70 + 14.30 HST = $110.00
  Payment Method:*
• Personal Cheque Institutional Cheque (Myself Only) Institutional Cheque + Others
• List names of additional registrants:

Please make cheques payable to:

CAREB c/o Patrick Clifford | Suite 512, Medical Arts Building | Southlake Regional Health Centre | 596 Davis Drive, Newmarket, Ontario | L3Y 2P9

Contact information: pclifford@southlakeregional.org

Receipts will be available at the conference.

Hotel Information:

Hilton London Ontario | 300 King Street | London, Ontario | N6B 1S2 | 519-439-1661 | www.hiltonlondon.com

Reservation Method (Individual call-in):

• Standard Rate: $103.00
• Overnight Parking: $6.00+
• Business Class Option: $143.00

Rooms must be booked by November 4th to receive the discounted rates listed above.

Parking Information:
Individual guests can stop by the front desk and state they are with this event for reduced event parking available at $4.00 in the Hilton garage based upon availability.Additional parking will be available at the corner of King and Waterloo.