Handling a WSIB Mental Health Claim - Thursday April 19 2012 (Mississauga)
|
Please fill out the following information and click submit to register for the above session. A confirmation e-mail will follow.
|
| First Name:* |
|
| Last Name:* |
|
| Email:* |
|
| Company Name:* |
|
| Job Title:* |
|
| Address: |
|
| City:* |
|
| Postal Code:* |
|
| Phone Number:* |
|
| Fax: |
|
| Payment Method:* |
MasterCard Visa |
| Name on the MasterCard/Visa: * |
|
| MasterCard/Visa #:* |
|
| MasterCard/Visa Expiry Date:* |
|
| P.O. Number (if applicable): |
|
| I have a Training Gift Certificate. My number is: |
|
| How did you hear about the event:* |
E-mail
Friend or colleague
I am a previous attendee
Website
Facebook
Twitter
LinkedIn
Clear Path Newsletter
Clear Path Employee
|
Do you know someone else that would be interested in this session?
Name: |
|
| Email: |
|
Cost is $149+HST (Register by two weeks prior and pay only $125+HST)
|
| * Indicates field is required. |
|
