Smart Spa Solution

Seminar Registration Form

September 26, 2006, 9:30am – 4:00pm

Fairmont Chateau Laurier Hotel
First Name:  
Last Name:   

Company Name:

  

Phone Number:

  
E-mail Address:  

Fee Per Person

Full day Seminar, Info Binder, Coffee Breaks & Lunch included

 Before Sept. 1, 2006: $85 + GST = $90.10         After Sept. 1, 2006: $120 + GST = $127.20

Method of Payment
GST #: 89 125 7354 Select

Please charge selected credit card  for the above amount:   

MC  
VISA  

Card Number:   

                               

Expiry Date:   

MM YR

 

 MM YR
   

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Please Print, Sign and Fax this form to :  613-749-2915