Short Course Registration Form

Contact information:
Name  
 
Address  
 
City  
  
Province  
  
Postal Code  
 
Telephone  
 
Email  
 

Affiliation (check one)
York student 
York staff 
York faculty 
non-York full-time post-secondary student 
external participant 

Please register me for the following courses:
Course Title
Course Instructor
 Fee
Certificate
 1.     $  $
 2.     $  $
 3.     $  $
 4.     $  $
 5.       $  $
 6.       $  $
 7.      $  $
 8.      $  $
 9.      $  $
Total Amount Due (Fees + Certificates)  
 $  

Method of Payment (check one):
Send a cheque or money order payable to York University to:
Betty Tai, Institute for Social Research
Room 5075, Victor Phillip Dahdaleh Building (DB
)
York University, 4700 Keele Street, Toronto, ON   M3J 1P3
Pay by VISA:
phone Betty Tai at 416-736-5061,
weekdays from 10:00am to 12:00pm or 2:00pm to 4:00pm
Pay in person:
see Betty Tai, Room 5075, Victor Phillip Dahdaleh Building (DB)
weekdays from 10:00am to 12:00pm or 2:00pm to 4:00pm