2017 Convocation Gala

ATTENDANCE FORM

Grad Name / Student ID Number
Program / MBA DBA BADM BCOMM BMAN / Grad Date (Month/Year)
Welcome Reception - Friday, June 9, 2017
Connections Café, Lobby Level, The DoubleTree by Hilton West Edmonton Hotel
I will attend the reception: / Yes No
No. of people attending reception (including Grad):
Shuttle Transportation to Athabasca – Saturday, June 10, 2017
Depart DoubleTree Hotel: 8:45 a.m. (approx.)
Return to DoubleTree Hotel: 5:00 p.m. (approx.)
No. of people requiring transportation:
Special Needs:
I / we will be staying at The DoubleTree Hotel: / Yes No No. of Rooms Booked:
Gala Dinner and Dance – Saturday, June 10, 2017
Grand Ballroom, Lobby Level, The DoubleTree by Hilton West Edmonton Hotel
I / we will attend the Dinner (If yes, please complete all sections below.) / Yes No
Guest Names: (Please indicate children’s age and gender (12 and under) if applicable. Attach additional sheet if required.)
1. / 2.
3. / 4.
5. / 6.
7. / 8.
9. / 10.
Special Needs or Diet Requirement:
Seating Preference: If you would like to be seated with a specific grad / family, please provide their name here.
TYPE OF MEAL / No. of MEALS / Total Amount

Adult Dinner

/ @ $75.00 each / $
Child Dinner (12 and under - adult meal) / @ $50.00 each / $
Child Dinner (12 and under - Chicken Fingers) / @ $15.00 each / $

TOTAL AMOUNT DUE

/ $
Payment is due June 2, 2017. You will be sent an e-mail notification 14 days prior to the payment deadline requesting that you pay your miscellaneous fees by the due date. This payment will be processed through a secure online banking payment site.
If you prefer to pay by cheque, please indicate by checking this box.
Please send cheque to: Athabasca University, Suite 201, 13220 St. Albert Trail NW, Edmonton, AB T5L 4W1
Cancellations received after June 2, 2017 are non-refundable.

FAX or Email form no later than April 30, 2017 to: Jill Grandy

Fax No: 780-447-7267

Email: