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Dairy Farmers of New Brunswick
If you would like to register as an exhibitor please email nbmilk@nbmilk.org for more information.
Name
*
First Name
Last Name
Email
*
example@example.com
I am a
*
New Brunswick Producer
New Brunswick Delegate
Guest
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Producer
Producer Number
*
Farm Name
*
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Please list the organization you are representing.
*
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I am attending: Choose all that apply:
*
Meeting
Lunch
Banquet
Please list your dietary needs.
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I am attending: Choose all that apply:
*
Meeting $75
Lunch $30
Banquet $80
None of the above $0
Please list your dietary needs.
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Guests
Do you have any other guests attending with you
*
Yes
No
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Guest one's name:
*
First Name
Last Name
Guest one will be attending:
*
Meeting $75
Lunch $30
Banquet $80
Please list Guest one's dietary needs.
Guest two's name:
First Name
Last Name
Guest two is attending:
Meeting $75
Lunch $30
Banquet $80
Please list Guest two's dietary needs.
Guest three's name:
First Name
Last Name
Guest three is attending
Meeting $75
Lunch $30
Banquet $80
Please list Guest three's dietary needs.
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Calculation
*
Total Payment
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( X )
CAD
Description
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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