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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 later at the first session) 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 _____________________________________________________________________________________

 

Home PHONE ______________________________________________________________________________________________

 

Work 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.)