Registration
Name
Title
Affiliation
Street Address
City
State/Province
Zip
Phone
Fax
E-mail
Website Address
Yes, I will attend the 1:30 p.m. reception prior to the keynote address.
Please choose one:
Public Office Holder
Current Student
Business Associate
University Faculty or Staff Member
Interested Citizen
Media
Off-Campus Professional
Yes, I would like to be added to the Canadian Studies Centre mailing list.
