Your Name *

Title First Name Last Name

Email *

Address *

Address Address 2 City Province Postal Code

Participant Type *

Your attendance fee is based on this option.

Will you be bringing guests? *

Yes
No

Guests *

See below for different guest options:

Guest Name	Option
Guest Name	Option

Free Guest Discount

Price: $ 0.00 CAD

Accessibility Concerns

Please enter any accessibility concerns for you and/or your guests if necessary.

Allergies / Dietary Notes

Please enter any dietary restrictions for you and/or your guests if necessary.

Accommodation Details

FOR RESIDENTS:

Personnel from Ardeane Healthcare Solutions will contact you in early-mid April and will arrange your hotel reservations for you, where applicable. Those residents residing out of the Greater Toronto Area (GTA) will be provided with complimentary (shared) accommodations on Thursday, May 23. You will be asked to share a room with a room-mate, and in a survey question below, please indicate your preferred room-mate. Individual rooms may be available for a fee of $150/night and pending availability. Please DO NOT book your own accommodations unless advised by Ardeane.

FOR PROGRAM DIRECTORS/FACULTY:

Hotel reservations for Thursday, May 23 will be booked directly for you by Ardeane Healthcare Solutions. You will receive a follow-up/confirmation email in April.

Sessions / Workshop Options

Room Options

Special Event Options

Survey

Please fill in the following:

Question

Answer

Question

Program Affiliation

Please identify the program/hospital you are affiliated with:

REQUIRED

Question

PGY level (RESIDENTS ONLY)

Identify your PGY level

OPTIONAL

Answer

PGY4
PGY5

Question

Thursday Accommodations (May 23 - NON-GTA)

Please advise if you require accommodations on Thursday night (May 23)?

OPTIONAL

Answer

Yes
No
Unsure

Question

Roommate Selection (RESIDENTS ONLY - NON - GTA)

Please identify the name of your desired room-mate for shared accommodations. If you wish to not share a room, additional costs of $150/night will apply and access will be based on availability.

OPTIONAL

Answer

Question

Travel Guidelines & Expense Reimbursement

Please confirm you have read and understand the TRAVEL GUIDELINES for this event. Reimbursement for travel expenses will be provided as a bursary after the event.

REQUIRED

Answer

Yes
No

Total

$ 0.00 CAD

2023 ORA Residents' Education Day

Ontario Rheumatology Association