Public Workshop Online Registration

Please complete all required fields (select workshop, enter attendee and billing information).



Mental Illness and Addiction - Co-occuring Disorders

				* required fields
	Workshop Information:
				Date and Location	Price
		Select Workshop:	*
				Early registration discount:
				Subtotal:

				Total:
		GST exempt registration is not available online. Please mail or fax your registration to our office or call 1-877-353-3205 for more information. Group rates are available for 4+ people, please fill out the group registration form. To receive group rate, you must register by mail or fax.


	Attendee Information:
		Name:	*
		Organization:
		Position:
		Email address:	*
		Confirm email address:	*

		Phone Number:	*
		Fax Number:

		How did you find out about this workshop?
		How did you find out about this workshop?



	Billing Information			* information must match credit card

		Name:	*		*
		Organization:
		Address:	*		*

		City:	*		*
		Province:	*		*
		Postal Code:	*		*