Correctional Service Canada
www.csc-scc.gc.ca
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Print Resources 2009
Restorative Justice Week 2009
2009 NATIONAL RESTORATIVE JUSTICE SYMPOSIUM
November 18th - 20th, 2009
The Battery Hotel
St. John’s, Newfoundland
Communities Responding to Human Needs
REGISTRATION FORM
| Please print name you would like to appear on name tag First Name: |
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|---|---|
| Last Name: | |
| Organization: | |
| Mailing Address: | |
| City: | |
| Province: | |
| Postal Code: | |
| E-mail: | |
| Telephone: | |
| Fax: | |
| Do you have any dietary restrictions? Please specify: |
REGISTRATION FEE IS $125.00 PER DELEGATE
This rate includes all activities and events noted on the attached Agenda.
Although the following events are no additional cost, in an effort to keep our numbers in check please indicate your attendance at the following::
Banquet and Ron Wiebe Award Ceremony, The
Battery Hotel, 6:30 p.m., Thursday, November 19th.
□ I plan to attend. □ I do not plan to attend.
Working Breakfast, The Battery Hotel, 9:00 a.m., Friday, November 20th.
□ I plan to attend. □ I do not plan to attend.
Registration Fee $ 125.00
Total Payment: $ _______ * See payment options on page 2
Please Note - Sign up for the workshops will take place at the registration desk.
Be sure to sign up early as space may be limited.
Workshop I(a) & Workshop II(a) will have French/English interpretation.
Please print, complete this form & mail/fax it together with your cheque for payment in full
on or before November 1st.
Cheques must be made payable to:
Community Mediation Services
178 Waterford Bridge Road
St. John’s, Newfoundland
A1E 1E2
Telephone: (709) 631-0069 / Fax: (709) 722-1067
cms@nfld.net / www.cmservices.org
Noreen Byrne, Executive Director/Event Coordinator
| I prefer to pay the above noted amount via: | □ VISA □ MasterCard |
|---|---|
| Name as it appears on Card (Please Print) __________________ |
Credit Card Number __________________ Expiry Date _______ |
| Cardholder’s Signature ___________________ |
Cardholder’s Telephone Number (required) |
Hotel reservations must be booked directly with The Battery Hotel on or before November
1st.
Telephone: (709) 576-0040 / 1-800-563-8181 ~ Fax: (709) 576-6943
Email: reservations@batteryhotel.com
Be sure to mention you are with Community Mediation Services to qualify for our group rate.
Community Mediation Services
We look forward to welcoming you to
beautiful, historic St. John’s, Newfoundland
