Your Organization's Name
Location of Workshop
Contact Person
E-mail address
Phone
Fax
Mailing Address
City
Province
Postal Code
To help us prepare, please select your audience from the list below:
Employee/staff Union members Students Single parents Low/no income Support group Couples Addiction problem Other
We will need an overhead projector and screen for our presentation. Check which additional equipment you can provide:
TV & VCR
Flip Chart
Approximate number of people expected to attend?
Please submit your 3 preferred presentation dates & times:
Date: Time:
Invoice addressed to:
Special Arrangements or additional details:
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