AFASE at School Workshop Registration Form

Name:

Street Address:

City, Province,
Postal Code:

Telephone number:

E-Mail:

Please indicate:

Parent:

Student

Educational Assistant

Other

Community worker

Teacher

Please make cheque payable to
AFASE at School

Mail to:
AFASE at School
15 Beer Cres.
Ajax, Ontario
L1S 0A2

I will mail my cheque for $85.00:

I will send $85.00 by Interac
Email Money Transfer to
karen.robinson@afase.com:
If you choose this option, please
call 905-427-7524 to tell me the
answer to your security question.

I paid $85.00 using the Pay
Now button:

I will bring my payment (cash or cheque) $100.00 with me to the workshop:

Workshop Registration Form

Please reserve a place for me in the Advocating For Appropriate Special Education
workshop on Saturday, September 6, 2008 at 10:30 AM at the Ajax Public Library
55 Harwood Avenue S., Ajax, Ontario, L1S 2H8

Our children deserve the chance to reach their full potential

AFASE at school
Advocate For Appropriate Special Education