REGISTRATION
July 4 - July 9 2011
YOUR NAME ___________________________________________________
To appear on your certification – please print.
___________________________________ POSTAL CODE ______________
YOUR SCHOOL
NAME
Your position: ________________________________________________
PH:
FAX: ________________email __________________________________
____A cheque for $950 ($850 if paid in full by May 15) made payable to WMTC is enclosed.
*+____ Student
Fee: $25. If you are
not currently a student member of the Western Montessori
Alumni Association, please also remit $25.
____Please debit my Charge Credit card Visa/Mastercard $_______ #__________________________________________expiry _______/________
Signed _______________________________________
Confirmation will be emailed –please ensure your current email address is included and is legible. Thank you.
Please
note: Certification
will be issued only to those participants meeting all course requirements
and
having 100% timely attendance. Please email wmtcab@telus.net
with any questions.
Please FAX your completed credit card registration to 403-949-2366 (a secure line)
or PHONE 403-949-2238.
or MAIL to:
A tuition receipt will be issued for tax purposes at the conclusion of the course.
In the unlikely event that this course does not proceed, all fees will be refunded within 30 days of
any cancellation by WMTC. There is a $100. Admin fee for any changes in registration after May 15th.
We recommend you retain a copy of this information and your completed registration form.