Equine airway disease workshop registration form

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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
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