53rd Mackid Symposium Registration Form

Please enter the following information to complete the registration process
Registrant Name:
Registrant Email:
Registrant Phone:
Registration Type:

Payment by Cheque

Payment by Credit Card
Please make sure cheque payable to AHS - Department of Family Medicine

Mail your cheque, along with a copy of this registration form to:

Zunaira Ahmad
AHS - Department of Family Medicine
Sheldon M. Chumir Health Centre
8th Floor, 1213 - 4th Street SW
Calgary AB T2R 0X7
PLEASE NOTE:The online payment tool will not function properly on mobile devices, including cell phones and tablets. Please use a desktop computer or laptop to complete your transaction online.

1) Go to: www.albertahealthservices.ca/pay
2) Under All Payments, click Get More Info
3) Under Pay Now, click Pay Now
4) Enter Routing Number (5500), and click I understand and agree to the terms and conditions." Click Next Step

5) Type in Contact Information and click Next Step
6) Type in your profession and click Next Step 7) Type your name and enter $75.00 as the amount. Click Add Invoice, then click Next Step
8) Confirm your Credit Card Billing Information, and type in your Payment Information. Click Submit Payment.
Cancellation Policy:

Requests for cancallations or substitutions must be submitted in writing to Zunaira Ahmad, zunaira.ahmad@ahs.ca. There will also be no refunds after September 18, 2019, however substitutions are permitted.

Thank you, your reservation has been confirmed!