Registration Form

To register in advance for a class, complete this form and either:

• e-mail this information in advance (to put your name on the class list, and submit payment at the workshop) to :

                                            Kathy at  ksomers@uoguelph.ca  

           OR

• mail this information, with a cheque payment, to :

                                             The Stress Management Clinic, Box 7323 U.C., University of Guelph, Guelph ON N1G 2W1.

NAME ____________________________________________________________________________________________________

ADDRESS & Postal Code _____________________________________________________________________________________

PHONE ___________________________________________________________________________________________________

E-mail address ____________________________________________________________________________________________

PROGRAM that I am registering for ___________________________________________________________________________

PROGRAM start date / time _________________________________________________________________________________

FEE enclosed _____________________________     (Please make cheques payable to the Stress Management Clinic.)

                     if not submitting payment  (cash or cheque) in person at the workshop