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Page 1: G zdinner2012 ticketpurchaseform

Event Information The Government of Canada, in partnership with the Canadian Chamber of Commerce in Shanghai (CanCham Shanghai), Canada China Business Council (CCBC), and the Canadian Chamber of Commerce in Hong Kong (CanCham HK) is pleased to announce the Canada-China Business Dinner at the Shangri-La Guangzhou on Friday, February 10, 2012. The Right Honourable Stephen Harper, Prime Minister of Canada, will provide the keynote address.

Date of Event: February 10th, 2012 Event Time: 6:30pm – Late; Dinner Reception Event Location: Shangri-La Hotel, 1 Hui Zhan Dong Road, Hai Zhu

District, Guangzhou, China

TICKET PURCHASE FORM

� RMB 1800 each X _________ CANCHAM members (Quantity)

� RMB 3600 each X _________ Non-members (Quantity)

� RMB 30,000 each X _________ Corporate Table Tables include 8 seats. An additional 2 seats at each table (for a total of 10) will be filled by the organizers at their discretion. * Tables will be located at the discretion of the organizers.

Name: Position:

Company: Address:

Telephone: Fax:

E-mail:

Please write below the name(s), title and company name of the guest(s) using the banquet ticket(s).

Cancellation policy: Cancellations, less a 10% administration fee, will be refunded until February 6, 2012. No refunds will be made after February 6, 2012.

Page 2: G zdinner2012 ticketpurchaseform

Full NameTitle

Organization

CASH PAYMENT OR BANK TRANSFER ONLY – Your ticket(s) will be confirmed upon receipt of full payment.Please send cash payments in Shanghai to the following officer and address:

To: Rebecca Copelovici/瑞贝卡 Rm 2805, 172 Yuyuan Road 中国上海市愚园路 172 号 2805 室

BANK TRANSFER INSTRUCTIONS:

Cancellation policy: Cancellations, less a 10% administration fee, will be refunded until February 6, 2012. No refunds will be made after February 6, 2012.

Page 3: G zdinner2012 ticketpurchaseform

Bank Name： China Construction Bank, Jing An Sub Branch

开户行：中国建设银行静安支行　

Bank Address：172 Yuyuan Road, Jing An District, Shanghai china

开户行地址：中国上海静安区愚园路 172 号

Account Name： CARLEE PULFORD　

Account Number：6227 0012 1684 0439 214

Swift Code：PCBCCNBJSHX　

Cancellation policy: Cancellations, less a 10% administration fee, will be refunded until February 6, 2012. No refunds will be made after February 6, 2012.

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