Children

REGISTRATION DEADLINE: TUESDAY, MARCH 11, 2014

1. Name, Organization and Title, or Educational Institution and Student Number (if applicable):

Matter

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2. Phone AND Email:

3. Special forum needs/requirements, including dietary restrictions (please elaborate below):

4. REGISTRATION FEE CATEGORIES (please circle one of a. or b.):

INVOICE REQUIRED (please circle yes or no): Yes No

a. Regular: $50.00 b. Student: $25.00

Signature and date signed: *** REGISTRATION FEES MUST BE RECEIVED PRIOR TO START OF CONFERENCE. *** PLEASE MAKE ALL CHEQUES PAYABLE TO: KA NI KANICHIHK INC. AN EMAIL CONFIRMING THE RECEIPT OF YOUR REGISTRATION FEE WILL BE SENT TO YOU MAIL REGISTRATION & PAYMENT TO: ACM CONFERENCE COMMITTEE, 705 BROADWAY AVE., WINNIPEG, MB R3G 0X2 OR FAX REGISTRATION FORMS TO 204.783.6343 & THEN MAIL IN PAYMENT TO SAME ADDRESS AS ABOVE *** REGISTRATION WILL NOT BE PROCESSED UNTIL REGISTRATION FEE IS RECEIVED *** FOR FURTHER INFORMATION ON ALL REGISTRATION MATTERS, PLEASE CONTACT: SHOHAN ILLSLEY: 204.783.6184 shohan@the595.ca IF YOU ARE INTERESTED IN SETTING-UP A BOOTH FOR YOUR ORGANIZATION AT OUR FORUM, CONTACT: NAHANNI FONTAINE: 204.945.7812 nahanni.fontaine@leg.gov.mb.ca
Funding for this forum provided by Tracias Trust, Manitoba Sexual Exploitation Strategy, Province of Manitoba.

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