The Family Education and Support Centre

Print & Mail in Registration
Upon receipt of your "Registration by Mail" form, the registrar will contact you to confirm your registration. 
Please call the Centre at 604-467-6055 if you have not received confirmation.
   

Name:

 

Full Address:  
Phone:  
Fax:  
Email:  
Course Name:  
Course Date:  
Payment Method  
Cheque:
Money Order:
Credit Card:
Card Type:  
Credit Card #  
Expiry Date:  
Cardholder's Name:  
 
Cardholder's Signature: 		 
 _________________________________________
 
Become a Member? 		 
  Yes:  No:
   
 
   
   

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