2017 AGM Registration and Payment Option Form
June 14-16, 2017 Casino Regina 1880 Saskatchewan Drive Regina Saskatchewan S4P 0B2
REGISTRATION FEE : $200.00 per person
Name and title for the AGM participant
Your answer
Payment Option
Please select payment option *
If you selected the cheque payment option, please note that the AGM registration fees are payable to the Gaming Security Professionals of Canada.

The cheque must be sent to the following address:

Gaming Security Professionals of Canada
500 Sherbrooke West, 7th Floor (security department)
Montreal, Quebec
H3A 3G6

Credit Card
If you have selected credit card payment option please fill out the required information below.
Do not send written information related to your credit card
Person to contact to obtain the credit card information?
Your answer
Phone number where that person can be reached:
Your answer
Ideal time to reach that person?
Your answer
Time Zone :
Dietary Restrictions
Contact Person
Jaude Pominville -- (514)268-0434 or Jaude.Pominville@loto-quebec.com
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