Doctors Manitoba | Awards Gala Member Tickets

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Awards Gala Member Tickets

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Title *

First Name *

Last Name *

Email *

Email address where you would like payment confirmation and ticket details sent.

Award Gala Ticket Purchase

You can purchase individual tickets for an early bird price of $175 each. Early bird pricing is in effect until April 15.(Please note that only Visa and Mastercard are accepted.)

Number of Individual Tickets

Number of Tables (10 seats)

If you have purchased a table, how do you want it titled? (eg. Rady Faculty of Medicine)

Guest Information

You can enter guest names and information now, or you can contact us in the future with this information. If no guest information is received by April 26, guests will automatically be assigned the Chicken option for dinner.

Note: on mobile devices, you may need to scroll to the right to be able to specify meal preferences, allergies and dietary restrictions for each guest.

Title *	First Name *	Last Name *	Meal Preference *	Allergies *	Dietary Restrictions *

Seating Preference (optional)

Please indicate if you want to be seated with other individuals attending the event not included in this order. Include their names, and will do our best to seat you together.

Sponsor a Medical Learner (optional)

You can sponsor a medical learner to attend our awards celebration, and with your consent you will be recognized for this generous support. We will work with the MMSA and PARIM to identify medical learners interested in attending. Medical learners are the future of our profession and including as many of them as possible in this event helps to build relationships and offer inspiration for excellence as they transition into practice.

Number of Medical Learner Sponsorships

Tickets are $175 each

Do you consent to being recognized as a sponsor at the awards celebration?

Yes

Optional: If desired, please add the names and email addresses of medical learners you wish to sponsor below.

Medical Learners

Total

Billing Details

Please note that only Visa and Mastercard are accepted. Sorry for any inconvenience.

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

Province (2 letter abbreviation) *

Postal Code *

Credit Card *

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Awards Gala Ticket Purchase for Members

Award Gala Ticket Purchase

Guest Information

Sponsor a Medical Learner (optional)

Billing Details