Canadian Summit in Multiple Myeloma

1.

Name

First name *

Last name *

2.

Mobile phone number *

3.

Email *

4.

Please select all nights you will be staying at Sutton Place Hotel Vancouver *

The cost of up to 2 nights will be covered.

Friday, February 5

Saturday, February 6

5.

Do you require a flight to and from this meeting? *

Yes

No

6.

Do you collect travel rewards? *

Yes

No

7.

In case of emergency, who is the best person to contact? *

Please provide name, relationship to you and phone number.

8.

Do you have any food allergies or dietary restrictions? *

Yes

No

9.

Are there any other special requirements that you will need accommodated? *

Yes

No

10.

Any questions or comments?

General Information