Registration Form

Please see seminar dates and times on the detailed pages for each course.
Payment information is below. Please fill out the form in full and either submit
through website or print form and mail to address below. You may also print & fax the
print version of this form to 1-800-403-0821. Please ensure payment is made at
least 3 days prior to seminar date.

Seminar Title: *
Seminar Date: *
Name *
Title: *
E-mail: *
Name 2.
Title:
E-mail:
Name 3.
Title:
E-mail:

Company:
Mailing Address: *
City: *
Province: *	*
Postal Code: *
Telephone: *		Ext.
Fax:

Payment Options

1) Cheques:

Payment must me made in full 3 days prior to the date of seminar by a cheque payable to Wayne P. Edworthy Inc. and mailed directly to:

Wayne Edworthy
Wayne P. Edworthy Inc.
16998 84th Avenue
Surrey, BC V4N 4V3

2)Credit Card
If you would like to pay by credit card please click in the box below and you will be contacted by phone to have your credit card billed. YES, I would like pay using my credit card

Cancellations and Substitutions. Cancellations received up to ten working days before the seminar are 100% refundable. Cancellations received within 10 days of the seminar date are subject to a 20% service charge (administrative fee). If you fail to cancel and not attend you are responsible for payment. Substitution is allowed.

* Required Fields