Registration

Form Submitted By:

Your email (You will receive a confirmation email at this address after submitting)

Date:

University

Contact Person:

Name:

Telephone:

Email:

Mailing Address:

Second Contact Person (Optional):

Name:

Telephone:

Email:

Mailing Address:

Entry Fee: $450 per team ($400 for a second team)

We would like to register one team – we will be sending a cheque for $450 made payable to the 'Canadian Client Consultation Committee'.

If space is available, we would like to register a second team. We will provide an additional $400 to register our second team, once advised by the Committee that there is space.

Reminder: Please send cheque(s) to:

Questions?: Go to www.clientconsultationcomp.ca, email clientconsultationcomp@gmail.com or contact Nicole Smith at 250-734-4145.