Registration - The Michener Institute

Registration for the Friday Workshop is now closed, but we are still receiving registrations for the rest of symposium (Friday poster rounds/welcome reception, & Saturday oral presentations).

Name*
First Last
Email*
Phone*
Organization/Clinic*
Primary area of practice*
Please specify, if you choose other:*
How would you describe your role*
Please specify, if you choose other:*
How did you hear about conference*
Please Specify:*
Do you have any special dietary considerations?*
- Yes
- No
Please specify:*
- Check this box if you would like receive information about future events hosted by the Research Institute of Health Education
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please note the education workshop is limited to 48 participants.
- I will be attending "Education Workshop" on April 26, 2019.
Registration Fee (Includes meals, social event and workshop)
Price: $ 25.00 CAD