Evenings With The Astronomers
Spring 2018 Lecture Series


Maximum number of participants: 30

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

"EWTA Lecture Series - Spring 2018 - Registration Request

"Although I expect the program providers to make every effort to accomodate the stated needs of all participants, they cannot be held responsible/liable for any adverse food-borne allergic reaction(s) while participants are attending the above-stated lecture series."
- I(we) agree with the above statement. (confirmation by marking the checkbox is required if you want to attend)
Please provide the following information...
Registrant's Name:
    Fee Category:
     General ($125+tax=$141.25); Returning ($100+tax=$113.00); or Student ($75+tax=$$84.75)
Second Registrant's Name
(if applicable):
   & Fee Category:
     General ($125+tax=$141.25); Returning ($100+tax=$113.00); Student ($75+tax=$$84.75); or Not Applicable
Payment Method: e-transfer; cheque (by mail); cheque (will drop off); cash (will drop off); or Not Applicable
Contact e-mail:
Contact 10-digit phone#:
Favourite Pastry/Cookie:
Please choose one of the following...
- I WILL ATTEND on WEDNESDAYS (April 11, 18, 25, May 2).
- I want to come, but CANNOT ATTEND on WEDNESDAYS.
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)
- Tuesdays: Apr.10, 17, 24, May 1
- Thursdays: Apr.12, 19, 26, May 3
- Fridays: Apr.13, 20, 27, May 4
- Saturdays: Apr.14, 21, 28, May 5
- Sundays: Apr.15, 22, 29, May 6
- Mondays: Apr.16, 23, 30, May 7
Comments and additional info:

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