local prosperity 2016 a regional conference on new ... · the conference hashtag is #lp2016...

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Local Prosperity 2016 A Regional Conference on New Economics for Rural Canada November 3-6, 2016 Miramichi, New Brunswick REGISTRATION FORM First Name: ___________________________________________________________ Last Name: ___________________________________________________________ Address: ___________________________________________________________ ___________________________________________________________ Email: ___________________________________________________________ Phone: ___________________________________________________________ Organization: ___________________________________________________________ Title (if applicable): ___________________________________________________________ Full Conference Registration (includes Thursday Night Keynote Address, Fri‐Sun conference and lunches, and Saturday Night Entertainment at the Vogue Theatre) General Registration $ 400.00 General Registration (Early bird before Sept 23, 2016 5:00pm) $ 350.00 Friday night banquet ____ x $50.00 *SEE BELOW ____________ SUBTOTAL ____________ HST (15% as of July 1, 2016) ____________ TOTAL REGISTRATION ____________ Make cheques payable to: City of Miramichi Mail to: City of Miramichi 141 Henry St. Miramichi, NB E1V 2N5 Attention: Local Prosperity Conference Credit Card: Visa MasterCard American Express Name on Card: ______________________________ Card Number: _____________________ Expiry: Month ______ Year _____

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Page 1: Local Prosperity 2016 A Regional Conference on New ... · The conference hashtag is #LP2016 @ProsperityLocal and @MiramichiNB CentreForLocalProsperity If you would like to be added

   

 Local Prosperity 2016 A Regional Conference on New Economics for Rural Canada   November 3­6, 2016 Miramichi, New Brunswick  REGISTRATION FORM  First Name:    ___________________________________________________________    Last Name:    ___________________________________________________________  Address:    ___________________________________________________________        ___________________________________________________________  Email:      ___________________________________________________________  Phone:      ___________________________________________________________  Organization:    ___________________________________________________________  Title (if applicable):  ___________________________________________________________   Full Conference Registration (includes Thursday Night Keynote Address, Fri‐Sun conference and lunches, and Saturday Night Entertainment at the Vogue Theatre)   �  General Registration             $ 400.00  �  General Registration (Early bird before Sept 23, 2016 5:00pm)  $ 350.00 

     �  Friday night banquet  ____  x $50.00   *SEE BELOW    ____________  SUBTOTAL                ____________  HST (15% as of July 1, 2016)                                                                ____________  TOTAL REGISTRATION            ____________ 

Make cheques payable to: City of Miramichi 

Mail to:   City of Miramichi   141 Henry St.  Miramichi, NB E1V 2N5  Attention: Local Prosperity Conference 

Credit Card: � Visa � MasterCard � American Express

Name on Card: ______________________________ Card Number: _____________________

Expiry: Month ______ Year _____

Page 2: Local Prosperity 2016 A Regional Conference on New ... · The conference hashtag is #LP2016 @ProsperityLocal and @MiramichiNB CentreForLocalProsperity If you would like to be added

Thursday Night Keynote Address (no cost) 

Additional Attendees:   ________________________________________________________________________ 

__________________________________________________________________________________________________ 

Generosity Policy 

Financial assistance may be available for those unable to pay the full registration fees, depending on the level of donations and sponsorship support received. If you request, we will put your name on a waiting list. However, being on this list does not confirm your registration and attendance. We will try to let you know 1‐2 months before the conference if a reduced registration fee amount is available for you.  

As best insurance to get into the conference, we encourage you to go to local sources first to raise all or part of your funding.  When asking for donations from your local officials and businesses, you can suggest that you will share what you learned at the conference and return their generosity by giving back in‐kind all the knowledge that you have gained.  

To inquire about the Generosity Policy Email Us Here 

Donate for Generosity Policy scholarships  �  $ 10.00             �  $ 25.00             �  $ 100.00             �  $_______  Delegate Cancellation Policy  Cancellations prior to 5:00 PM, Friday, September 2, 2016, will not be subject to any cancellation fee. Cancellations prior to 5:00 PM, Friday, October 7, 2016, will be subject to a $70.00 cancellation fee. Cancellations after this time are subject to the full registration fee. Substitutions are welcome at no charge. 

 �  I would like to volunteer to help with this event 

  Lodging  Several choices of lodging are available for Wednesday to Sunday (November 2‐6) nights. Many accommodations are offering special rates for conference participants. When booking, refer to the Local Prosperity conference to get the special rates.  For details please visit: http://www.localprosperity.ca/accomodations/ 

 Breakout Session Preferences  Please number below from 1‐8 your priority preferences for the Breakout Sessions that you would like to attend the most (your answer will help us determine attendance and seating): ____ #1 Scaling Our Local Food Supply ‐ A Resiliency Cornerstone  ____ #2 Building Social Capital Pools, Social Financing & Impact in Entrepreneurial Ecosystems ____#3 Energy ‐ The Sources, Ownership and Distribution ____#4 Moving to Value‐Added & Ethical Restoration of our Fisheries ____#5 Rebuilding the Value Chain from our Forests ____#6 Government Power and Policy in the New Economy ____#7 Community‐Based Enterprises ____#8 Arts, Culture and Tourism in the New Economy     

Page 3: Local Prosperity 2016 A Regional Conference on New ... · The conference hashtag is #LP2016 @ProsperityLocal and @MiramichiNB CentreForLocalProsperity If you would like to be added

Local Harvest Banquet Menu:  Presented by:   Jesse MacDonald Executive Chef Rodd Miramichi River Hotel  1st Course:  Garden Salad 2nd Course: Harvest Vegetable Soup Main Course: Cranberry Braised 1/4 Chicken topped with Au Jus Dessert Course: Mixed Fruit Cobbler  Tea & Coffee Cash Bar  We will also be offering the following: Vegetarian Option    □ Vegan Option                  □  Food allergies/sensitivities    □ Please specify: _________________________________________________________________________________________________________________________________________________________ Other Dietary Restrictions    □ Please specify: _________________________________________________________________________________________________________________________________________________________ Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________  Social Media  We would like to encourage people to network with us on social media so that we might follow one another prior and during the conference, and stay in touch following the event. Therefore, if interested, we would like to invite you to provide your Twitter and/or Facebook details here: 

Facebook _________________________________________ 

Twitter    _________________________________________ 

The conference hashtag is #LP2016     @ProsperityLocal and @MiramichiNB  CentreForLocalProsperity 

 If you would like to be added to the Centre for Local Prosperity mailing list and receive occasional updates on events and news please check here  

See archival newsletters here: http://eepurl.com/ce4a7T 

For more information visit: www.localprosperity.ca