Your Personal Universe
Winter 2016 Lecture Series

"The Colourful Universe"


Maximum Number of places available: 12

-------------------- complete the form below and deliver it along with your payment to the address shown above --------------------

YPU Lecture Series - Winter 2016 - Registration Request

"Although I expect the DDO Defenders to make every effort to accomodate the stated needs of all participants, the DDO Defenders cannot be held responsible/liable for any adverse food-borne allergic reaction(s) while participants are attending the above lecture series."
- I(we) agree with the above statement. (confirmation by marking the checkbox is required if you want to attend)
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PAYMENT by: Mail (enclosed); eTransfer; or hand delivery (by Feb.1)
Registrant's Name:
    Fee Catagory: General ($141.25/169.50); Returning ($113.00/141.25); or Student ($84.75/113.00)
Second Registrant's Name:
    Fee Catagory: General ($141.25/169.50); Returning ($113.00/141.25); or Student ($84.75/113.00) Not Applicable
City/town:
Contact e-mail:
Contact 10-digit phone#:
Favourite Pastry/Cookie:
.
Please choose one of the following...
- I WILL ATTEND on FRIDAYS, Feb.5, 12, 26, Mar.4 (NOT Feb.19).
- I want to come, but CANNOT ATTEND on FRIDAYS.
.
If you would rather or need to attend on a DIFFERENT Day-of-the-Week, please indicate this below:
Other Dates you are Available: (check all that apply)
- Mondays: Feb.1, 8, 15, 22
- Tuesdays: Feb.2, 9, 16, 23
- Wednesdays: Feb.3, 10, 17, 24
- Saturdays (7-9 pm) (3-5 pm): Feb.6, 13, 20, 27
- Sundays (7-9 pm) (3-5 pm): Feb.7, 14, 21, 28
Comments and additional info:

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