Registration

Registrant Information

Workshop name(Required)

First Day of Workshop(Required)

Registrant's Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Do you wish to be included in any future training workshop or program notices?(Required)

Yes

Is payment being made by a third-party institution (Employer, sponsor, etc.)?(Required)

Yes

Employer/Sponsor Information

Division, unit or department

Name of Institution(Required)

Contact information if different than the registrant

Contact name if different than the registrant

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone(Required)

Email(Required)

Payment Instructions

Do you want to

complete your registration by credit card (Master Card and VISA only) or by Interac debit?

request an invoice and complete your registration payment by cheque, Electronic Funds Transfer or International Wire Transfer?

Note: You will be forwarded to our payments page once this registration form is submitted.

Cardholder's name

First Last

By default this is the registrant's name but you may change it here if someone else is the holder of the payment card that will be used for this transaction.

Invoice number

Payment amount(Required)

Please note this is the amount listed next to the course or on your invoice before HST

Total before tax

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