Your Information 
		Name   
		 
		    
		 
		
		Canadian Insurance Participant Registry 
		
		(CIPR#) - if you have one    
		  
		  
		Company 
		 
		
		  
		Address    
		 
		         
		 City    
		 
		    
		Province  
		
		BC 
		YT 
		AB 
		SK 
		MB 
		ON 
		QC 
		NB 
		NS 
		PE 
		NF 
		      
		 
		Postal Code  
		 
		    
		Business Phone  
		 
		 
		Home/Cell Phone
		 
		 
		 
		Fax    
		
		  Your Email Address 
		 
		
		 
		
		YOUR INVESTMENT TO ATTEND 
		 
		
		 
		
		QC Advisors please note  - You will not receive any PDUs 
		for attending the seminars in person or via Live Webstream, but you will 
		receive access to complete either 15 or 30 PDUs by using our Approved 
		QC PDU Course Catalogue   
		
		 
		
		AB Advisors  - Any approval #'s are listed on the agenda 
		page for the seminar that you are attending. You will receive a certain 
		amount of CE credit for attending the day. After the seminar is 
		completed, you will have access to complete a total of 15 or 30 CE 
		credits by using our Online 
		Course Catalogue   depending on the registration option you 
		choose. You will have 60 days to compete the additional ONLINE CE     
		
		 
		
		For BC, SK, MB -  (ID # if approved for MB Advisors is 
		listed on agenda page) ON, & Eastern Canada Advisors 
		
		 
		
		OPTION 1 - 15 CE Credits  - 
		Attend the full day and receive 6 CE credits for your attendance.  
		 
		
		 
		
		After the seminar is completed, you can complete up to an additional 9 
		CE credits using our Online 
		Course Catalogue   for a total of 15 CE credits. You will 
		have 60 days to compete the additional ONLINE CE     
		
		 
		
		Live In Person Attendance Special Pricing - $149.00 + TAX 
		 
		
		Livestream Webcast Attendance Special Pricing - $159.00 + TAX
		 
		
		 
		
		If you elect to attend the Livestream Webcast 
		option, you will be sent the access links to the email address that you 
		provided a couple of days before the scheduled date.    
		
		 
		
		OR 
		 
		
		
		 
 
		
		
		
		 
		
		OPTION 2 – 30 CE Credits  - Attend the full day and 
		receive 6 CE credits for your attendance. 
		
		 
		
		After the seminar is completed, you can complete up to an additional 24 
		CE credits by using our Online 
		Course Catalogue  . This will give you a total of 30 CE 
		credits. You will have 60 days to compete the additional ONLINE CE. 
		
		 
		
		Live In Person Attendance Special Pricing - $229.00 + TAX 
		 
		
		Livestream Webcast Attendance Special Pricing - $259.00 + TAX  
		 
		
		 
		
		If you elect to attend the Livestream Webcast option, you will be sent 
		the access links to the email address that you provided a couple of days 
		before the scheduled date. 
		
		 
		Seminar
		selection   
		  
		  
		Select One Please 
  
		
		 
		
		
					
		Will You be Attending the "LIVE" Seminar or 
		Viewing the "LIVE" Webcast   
		  
		  
		Select One Please 
		Attending In Person 
		Viewing Webcast 
   
		
		 
		
		IMPORTANT - Live Webcast Attendees - The start and finish times 
		are the same REGIONAL TIMING as the location you elected to get the 
		livestream webcast from.  
					
					
					Option   
		 
					
					
					Select One Please 
					Option 1 - 15 CE Credits 
					Option 2 - 30 CE Credits 
   
		 
					Questions? Type anything you need help with in the box
					below.
 
		
		 
		  
		   
		
		
		 
		
		 
		Substitutions may be sent at any time. All cancellations are
				subject to a $25 administration fee. To receive a refund, your
				written cancellation must be received a minimum of 21 days
				before the conference date. Refunds will not be issued after
				that date, instead we will issue a Credit less the
				administrative fee of $25 for any future Pro-Seminar event or
				self study course. This Credit will be valid for 12 months from
				the starting date of the cancelled event. It can also be
				redeemed by any employee of your company.