Claristery Workshop Registration Form

 

* Name:

Street:

 

 

City:

Province:

Postal:

* Tel 1:

Tel 2:

* E-Mail:

 

 

 

* Required

 

 

I would like to have vegetarian meals:

 

 

VISA:

Expiry:

mm / yy

 

 

Deposit:

$50.00 Full Fee: $280.00 Other Amount:

 

 

Comments:

 

 

 

 

Claristery

207-85 Norfolk St
Guelph ON N1H 4J4

Canada

(519) 836-1277
(519) 836-9880 fax
workshop@claristery.com

 

Dr. K. Greenaway, C. Psych.