Registration Form

Please print and complete the following form (or download a word document) and return it to:

Canada on Display,
c/o Dept. of History,
Lady Eaton College,
Trent University, Peterborough
K9J 7B8

If you provide an email address, we will acknowledge receipt of your letter and cheque. Receipts will be available at the Registration desk, Traill College Senior Common Room, from 11:30 am Friday April 13th on. PLEASE NOTE: WE CAN ONLY ACCEPT CASH AND CHEQUES.

NAME:	__________________________________________
ADDRESS:	__________________________________________
	__________________________________________
	__________________________________________
EMAIL:	__________________________________________
TELEPHONE:	__________________________________________
Any dietary or special accommodation needed:	__________________________________________ __________________________________________ __________________________________________

COST per person for the entire event, including lunch Friday and Saturday, coffee breaks, and banquet at Traill College on Friday April 13th: $50.00.

Cost for banquet only: $30.00.

Banquet time and place: Friday April 13th, 7:30 pm, following 7:00 pm Traill College reception in the Senior Common Room. (note: wine with dinner will be cash bar).