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Formulaire d'inscription/Sign Up Form | AMNQ Gala QBMA 2025
Date: October 3rd, 2025
Lieu/Venue: UdeM Campus MIL
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* Indicates required question
Nom au complet/Full name
*
Your answer
Courriel/Email
*
Your answer
Je participe à l'événement.../ I am attending the event...
*
Seul(e)/Alone
Accompagné/Accompanied (Je transmettrai ce formulaire à mes invités/I will forward this form to my guest(s))
Par combien de personnes serez-vous accompagné(e)?/ How many people will accompany you?
Your answer
Avez-vous des restrictions alimentaires? Si oui, veuillez préciser lesquelles / Do you have any dietary restrictions? If so, please specify. which ones
.
*
Your answer
Souhaitez-vous effectuer un don à l'AMNQ dans le cadre du Gala? (
Les dons soutiennent les bourses d'excellence de l'AMNQ. Merci de votre générosité!
) //
Would you like to make a donation to the QBMA as part of the Gala
?
(Donations support the QBMA’s Excellence Scholarship Program. Thank you for your generosity!)
*
Oui, en tant qu’étudiant·e – 25 $ / Yes, as a student – $25
Oui, en tant qu’adulte – 100 $ / Yes, as an adult – $100
Oui, autre montant / Yes, other amount
Non, pas pour cette fois / No, not this time
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