ONE-DAY EQUINE AIRWAY DISEASE WORKSHOP Saturday, May 3, 2014 Western College of Veterinary Medicine 8:30 am – 5:00 pm DELEGATE REGISTRATION FORM First Name: Last Name: Organization/Company Name: Address: City: Prov: Email: PC: Phone: REGISTRATION GST TOTAL $200.00 $10.00 $210.00 Workshop registration includes 7 hours of CE (3 hours of lecture and a 4 hour wet lab), 2 refreshment breaks and a lunch Dietary Restrictions: PAYMENT For credit card payment fax to: (306) 966-8747 Credit Card: Visa MasterCard Card Number: Name on Card: Cheque payable to: Cheque payment mail to: Expiry Date: Signature: University of Saskatchewan WCVM (Jackie Bahnmann) University of Saskatchewan, 52 Campus Drive, Saskatoon, SK S7N 5B4