EmailMe Form - Creating Pathways to Employment

Name of Registrant *

First Last

Organization *

Address *

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

Phone Number *

### - ### - ####

Email Address (Invoice will be emailed.) *

Confirm Email

Dietary Restrictions and/or Accommodation Needs

I am Registering for all Three Days for $270 (I save $90!) *

Yes!

No, I prefer to register for only the days selected below.

Day 1, November 2: The Art of Creating Opportunity ($120)

Day 2, November 3: Beyond Traditional Job Development ($120)

Day 3, November 4: 30 Ways to Shine as a New Employee ($120)

My Total Registration Fee is:
(Please adjust amount if you are only attending selected days.) *

$ Dollars . Cents

Once you submit this form, we will send you an Invoice by Email.

Payment can be sent to:

Denise Bissonnette Event
SCE LifeWorks
227 – 530 Century Street
Winnipeg MB R3H 0Y4

Please make cheques out to SCE LifeWorks
Refund Policy: Up to one week before event (October 26, 2015) full refund minus 10% admin costs.
After this date refund will be minus $100 for administration and event costs.

Additional Comments or Concerns