Your Name * Select a titleMr.Mrs.Ms.Dr. Title First Name Last Name Email * Address * Address Address 2 City Province Postal Code Participant Type *Your attendance fee is based on this option.Select a participant typeResidentWill you be bringing guests? * Yes No Guests *See below for different guest options:Guest NameOption Select an option Free Guest Discount Price: $ 0.00 CAD Accessibility ConcernsPlease enter any accessibility concerns for you and/or your guests if necessary.Allergies / Dietary NotesPlease enter any dietary restrictions for you and/or your guests if necessary.Accommodation DetailsSessions / Workshop OptionsFriday May 13 Plenary Education Sessions (8:30 am - 12:00 pm)* I will attend I will not attend Friday May 13 OSCE (12:30 - 5:25 pm)* I will attend I will not attend Room OptionsSpecial Event OptionsSurveyPlease fill in the following:QuestionAnswerQuestionProgram AffiliationPlease identify the program/hospital you are affiliated with:REQUIREDAnswer McMaster Ottawa Queen's U of T Western Other Not applicable QuestionPGY levelIdentify your PGY levelREQUIREDAnswer PGY4 PGY5 Total $ 0.00 CAD Subtotal Options Total Confirm Order