Fairmont Palliser in the Crystal Ballroom Sunday March 18, 2012 Cocktails at 12:30 p.m. Dinner to follow at 1:00 p.m 2012 Calgary Hitmen Awards Banquet Registration Form Name: _________________________________________________________________________________________________ Company Name: ________________________________________________________________________________________ Address: _____________________________________________________ Postal Code: _____________________________ Email: ________________________________________________________ Phone: ___________________________________ Number of Tickets: __________ FORM OF PAYMENT: Individual ($50) or Table of 10 ($450) (please circle one) Credit Card Type:
MC
Visa
AMEX (please circle one) _______________
Credit Card Number:__________________________________________________ Expiry Date: _______________________ Name of Cardholder _____________________________________________________________________________________ Signature _______________________________________________________________________________________________ Require receipt? Yes No
Cheque enclosed: Yes No
*Dress is business attire. If you wish to stay at the Fairmont Palliser either Saturday March 17 or Sunday March 18, the rate is $119 per room and you must reference the rate code “HITMEN”. Once your order is received you will be contacted via email or telephone to confirm if your ticket request was successful.
Please FAX registration form to 403-571-2211 or mail to: Calgary Hitmen P.O. Box 1540 Station M, Calgary, AB T2P 3B9