Registration Instructions for Saturday Workshop
Saturday, April 2, 2005

Fill in the form and return with your cheque payable to The Centre for Literacy or
VISA number to:

The Centre for Literacy, 3040 Sherbrooke Street West, Montreal, Quebec, H3Z 1A4.

For information:
Telephone: (514) 931-8731, local 1415     Fax: (514) 931-5181
E-mail: literacycntr@dawsoncollege.qc.ca
Web-site: http://www.centreforliteracy.qc.ca



REGISTRATION FORM - SATURDAY WORKSHOP

Grassroots: Community Writing and Arts 2005
Oral Traditions and multiple literacies

I enclose a cheque for Adult: checkbox $30     Student: checkbox $15

Or, please charge my   checkbox VISA

   Card #    Exp. Date

   Signature: ___________________________________________________

INFORMATION:

Name: ___________________________________________________________

Mailing Address:  checkbox  Home  checkbox Work:

_________________________________________________________________

City:______________________ Province: ______Postal Code: _____________

Organization:______________________________________________________

Telephone (Home): ___________________ (Work): ______________________

Fax: ___________________ E-mail: ___________________________________

Allergies / Dietary Restrictions: _______________________________________

_________________________________________________________________

Confirmation will be sent after receipt of payment.



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