LC Spring 2010 Champions Conference Registration

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1. * Please Provide the Following Information:
Name
eMail
Mobile Phone (if applicable)
(2 answer(s) required)

2. * Please provide the following information regarding your school district/organization and role within your district:
School District:
Name or Department:
Work Phone # Including Extension:
(3 answer(s) required)

3. * Do you require accomodation Thursday evening?



4. * Thursday April 22, 2010: Appetizer @ Schulich Executive Centre Dinner
Choose one:




5. * Thursday April 22, 2010. Entree @ Schulich Executive Centre Dinner
Choose one:






6. * Do you require a parking pass on Friday April 23, 2010?



7. In the space below, please list any dietary or other concerns you may have to ensure your needs are met at the conference.

Click FINISH to complete registration.

An email confirmation will follow in the near future from the Learning Connections Program Office confirming your registration. Should you have any further questions, please email lchelp@yorku.ca