2018 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 AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country 1. Choose the show(s) you are registering for:* Vancouver, BC (February 28, 2018) - Executive Airport Plaza Sarnia, ON (April 12, 2018) - Dante Club Mississauga, ON (May 10, 2018) - Mississauga Convention Centre Halifax, NS (May 30, 2018) - Halifax Marriott Harbourfront Ottawa, ON (September 18, 2018) - Nepean Sportsplex Montreal, QC (September 20, 2018) - Sandman Hotel Longueuil Calgary, AB (October 17, 2018) - Ramada Plaza Calgary Airport Regina, SK (November 7, 2018) - Delta Regina Do you plan on attending the Ottawa 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 Montreal 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 Calgary 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 Regina 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
