The Beanstalk Project - Calgary Launch

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Attendee Registration Form - Calgary Launch - March 19-21, 2010
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Attendee Registration Form

This form allows you to register on behalf of someone else (a teacher can register a student, for instance). Registrations are fully transferable, so if you're not sure exactly who is coming, not to worry.

Your registration is not considered complete until we receive payment and/or a bursary has been approved.

Once you have submitted this form and we have received it, we'll send you a confirmation email. If you have any questions, please email calgary@thebeanstalkproject.org

YOUR FIRST NAME *

Fill out YOUR info - the person who is submitting the registration

YOUR LAST NAME *

Fill out YOUR info - the person who is submitting the registration

YOUR EMAIL ADDRESS *

This will be our primary method of communication

YOUR PHONE NUMBER *

(Use whichever is best to reach you)

YOUR ALTERNATE PHONE

School *

(or organization)

Your Relationship to Attendee *

You are a ______ of the Attendee

I AM the attendee

Teacher

Counsellor

Friend

Parent / Guardian

Other:

ATTENDEE FIRST NAME

(Registrations are fully transferrable - if you don't know, you can leave it blank)

ATTENDEE LAST NAME

(Registrations are fully transferrable - if you don't know, you can leave it blank)

ATTENDEE EMAIL ADDRESS

This will be our primary method of communication

ATTENDEE PHONE NUMBER

Grade of Attendee *

9th

10th

11th

12th

5th year high school

University/College

ADDRESS

Where do we send any printed info

CITY

PROVINCE

POSTAL CODE

Tell us about your accommodation plans for the Launch weekend. *

While we're not providing accommodations, we will gladly help connect out-of-towners with students who want to host someone at their house.

I'll be staying at home - I can't host anyone

I'll be staying at home - I could possibly host someone

I'll be staying at home - I can definitely host someone

I'll be looking for a house to stay at

I think I'll be getting a hotel room, but I'd like to be connected with others who might want to share the room

I'll be staying in a hotel room, and I don't need to be contacted about other people wanting to share.

I don't really want to tell you - mind your own business.

I don't know yet. Ask me sometime later, or count on me to figure it out on my own.

Other:

Will a teacher from the school (or an adult from the organization) be attending the Launch also? *

Currently, the plan is to welcome the teachers (The Beanstalk Project will cover the registration fees of a teacher who wants to attend), but there is no specific programming planned. Briefly tell us your plan and any thoughts you have about how to best utilize the adults who are present.

A Great Investment!

Delegates will receive:
Friday Dinner, Saturday Lunch, Sunday Lunch, Snacks, amazing entrepreneurship training, interactive sessions and socials, ongoing mentoring, a Certificate of Participation, and a chance to win $200 seed money for their projects.

PAYMENT ($149 Early bird on or before Mar 3, $179 regular) *

I intend to pay with

CHEQUE (Make it payable to "The Beanstalk Project" - mail to 21 Paisley Avenue S, Hamilton, ON, L8S 1T8 )

BURSARY (in full or in part - if you select this, a short bursary application will follow on the next page) - We are committed to ensuring cost is not a limiting factor for youth who want to attend.

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