*Your First Name:
*Your Last Name:
*Job Title:
School Name:
*School District or Company:
Street Address:
*City:
*State or Province:
*Phone Number:
*Email Address:

*Registration Fees:
$189.00 individual rate
$149.00 per person for groups of five or more

*Number of Participants:
*Total Amount (Fee x No. of Participants) $

 
*Payment Method:
 
Check

Make checks payable to:
JK Thomas and Associates Ltd.

and mail to:
JK Thomas & Associates
204 10252 135th Street
Surrey BC
V3T 4C2
Canada

P.O.

 
P.O. Number:
 

Contact Person (if different from above):

Name:
Street Address:
City:
State or Province:
Zip/Postal Code:

Email to send invoice:

 
Credit Card