Fondation Cité de la Santé

Transaction

Registration - Laval Employees $75.00 / unit

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The $75 registration fee is reserved for Laval employees only. If this is not your case, please select OUTSIDE LAVAL.

Registration - Employees outside Laval $100.00 / unit

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Total:

Contact information

E-mail

E-mail confirmation

Title

First name

Last name

Country

Province

Street no.

Street name

Street type

Apt. / office

No. apt.

City

Postal code

Phone

Matricule

What is your registration number ? Madantory for Laval employees.

Payment

TOTAL amount

No payment methods available

Comments

Organization's registration number:

10293 3827 RR0001

Time remaining in your session: 40