2019 Process & Automation Shows Pre-Registration Name* First Last Job Title*Email* Phone*FaxCompany*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country 1. Choose the show(s) you are registering for:* Vancouver, BC (February 26, 2019) - Executive Airport Plaza MIssissauga, ON (April 3, 2019) - Mississauga Convention Centre Saint John, NB (May 15, 2019) - Hilton Saint John Quebec City, QC (September 11, 2019) - Hotel Plaza Quebec Winnipeg, MB (September 24, 2019) - Victoria Inn Saskatoon, SK (September 26, 2019) - Travelodge Hotel Edmonton, AB (November 6, 2019) - Holiday Inn Conference CTR Edmonton South Do you plan on attending the Vancouver Breakfast? Breakfast runs from 9:30 AM - 10:15 AM.*Yes, I will be attending BreakfastNo, I will not be attending BreakfastDo you plan on attending the Mississauga Breakfast? Breakfast runs from 9:30 AM - 10:15 AM.*Yes, I will be attending BreakfastNo, I will not be attending BreakfastDo you plan on attending the Saint John Breakfast? Breakfast runs from 9:30 AM - 10:15 AM.*Yes, I will be attending BreakfastNo, I will not be attending BreakfastDo you plan on attending the Quebec City Breakfast? Breakfast runs from 9:30 AM - 10:15 AM.*Yes, I will be attending BreakfastNo, I will not be attending BreakfastDo you plan on attending the Winnipeg Breakfast? Breakfast runs from 9:30 AM - 10:15 AM.*Yes, I will be attending BreakfastNo, I will not be attending BreakfastDo you plan on attending the Saskatoon Breakfast? Breakfast runs from 9:30 AM - 10:15 AM.*Yes, I will be attending BreakfastNo, I will not be attending BreakfastDo you plan on attending the Edmonton Breakfast? Breakfast runs from 9:30 AM - 10:15 AM.*Yes, I will be attending BreakfastNo, I will not be attending Breakfast2. Yes! I Want To Receive (Or Continue To Receive) A FREE Subscription To Canadian Process Equipment & Control News.*YesNoHow would you like your magazine delivered?*Choose one...PrintDigitalBoth3. Which of the following best describes your organization?Industry Group:*Choose one...Industrial ChemicalsPulp & PaperPetroleum, Coal & Natural GasPrimary PlasticsMetals ProcessingFood Processing & Beverage MFGNon-metallic MineralsPharmaceutials & MedicinesDetergents, Toilet Preparation, Soaps & CleaningRubber & Rubber ProductsProtective CoatingsThermal UtilitiesTextile IndustriesConstruction FirmsLaboratory PersonnelConsulting & Design EngineersGovernemnt EngineersEducational InstitutesOthers Allied to the FieldSpecific Industry (Industrial Chemicals):*Mfrs. Industrial ChemicalsMisc. Industrial ChemicalsAnimal Feed IndustriesMfrs. of Mixed FertilizersLeather TanneriesOther (Please specify below)Specific Industry (Pulp & Paper):*Choose One...Misc. Wood IndustriesPulp & Paper MillsAshphalt Roofing Mfrs.Paper Box & Bag Mfrs.Mist. Paper ConvertersOther (Please specify below)Specific Industry (Petroluem, Coal & Natural Gas):*Choose One...Coal MinesCrude Petroleum RefineriesPetroleum RefineriesMisc. Petroleum & CoalOther (Please specify below)Specific Industry (Primary Plastics):*Choose One...Mfrs. of Plastics & Synth ResinOther (Please specify below)Specific Industry (Metals Processing):*Choose One...Iron & Steel MillsSmelting & RefiningAluminum Rolling, Casting & ExCopper & Copper AlloyMetal Pressing, Stamping & COAGold Quartz MinesUranium MinesIron MinesMisc. Metal MinesOther (Please specify below)Specific Industry (Food Processing & Beverage Mfg.)*Choose One...Meat & Poultry IndustriesFish Product IndustriesFruit and Vegetable ProcessingDairy Products IndustriesFlour and Cereal IndustriesBakery Product IndustriesMisc. Food IndustriesBeverage IndustriesOther (Please specify below)Specific Industry (Non-Metallic Minerals):*Choose One...Clay Products ManufacturersConcrete Product ManufacturersGlass & Glass Product Mfrs.AbrasivesMisc. Non-metallic MineralCement ManufacturersReady-mix ConcreteLime ManufacturersAsbestos Mines & MillsGypsum Mines & MillsMisc. Mines & Mills Incl. SaltOther (Please specify below)Specific Industry (Pharmaceuticals & Medicines):*Choose One...Pharmaceuticals & MedicinesOther (Please specify below)Specific Industry (Detergents, Toilet Preparation, Soaps & Cleaning):*Choose One...Mfrs. of Soap & Cleaning Prod.Mfrs. of Toilet PreparationsOther (Please specify below)Specific Industry (Rubber & Rubber Products):*Choose One...Rubber & Rubber ProductsOther (Please specify below)Specific Industry (Protective Coatings):*Choose One...Paint & Varnish Mfrs.Other (Please specify below)Specific Industry (Thermal Utilities):*Choose One...Electric PowerGas DistributionOther Utilities Incl. NuclearOther (Please specify below)Specific Industry (Textile Industries):*Choose One...Cotton Yarn & Cloth MillsWool Yarn & Cloth MillsMan-made FibresFibre & Felt ProcessingKnitted Fabric Mfrs & MillsOther (Please specify below)Specific Industry (Construction Firms):*Choose One...Construction FirmsOther (Please specify below)Specific Industry (Government Engineers):*Choose One...Government EngineersOther (Please specify below)Spcific Industry (Educational Institutes):*Choose One...Education IndustriesOther (Please specify below)Please Specify:*4. FOR AUDIT PURPOSES ONLYIn lieu of a signature, please answer the following question.What is the first letter of the month in which you were born?*Choose One...JFMASOND
