Enter Workshop Dates:

Your Name (as it is to appear on your certificate)

Title

Organization

Address

City, Province, Postal Code

Phone

Email Address

Post-Secondary School

Student ID No.

To qualify for student pricing, students must submit a copy of their student identification card either as a scanned document attached to an email sent to info@vicrisis.ca or as a fax sent to 250-753-2475.

CIST Registration Part 2: Payment Method

As per our registration policies, payment must accompany this personal information form.

1. Credit Card by calling VICS (office is open Monday to Thursday, from 9 to 12 and 1 to 4)2. Credit Card at VICS office3. Cash or cheque at VICS office4. Cheque via post (not available within 10 business days of first date of workshop presentation)5. PayPal Shopping Cart6. eTransfer payment via etransfer@vicrisis.ca

 

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Additional Comments:

I have read and understood the Course Registration Policies. Yes

I understand that payment is REQUIRED to be registered. Yes