Clean Water for Ontario

Registration

Name:
Organization:
E-mail:

Mailing Address (optional)
Street:
City:
Province:
Postal Code:

Phone #:
Fax #:

Conference Fee (select one) $50 full fee $25 reduced fee

Payment (select one) Please bill me I will pay at the door.

Will you be making a submission, either as an individual or on behalf of an organization?  If so, please indicate the general theme or aspect of water management that you will be addressing:

Other Comments:
 

or