PEEL BRANCH                                      

 

Registration Form 2009-2010

Please check the workshop(s) for which you want to register and complete the information below!
 

Event Information
Yes Title Date Time Fees Deadline
  ASIST (suicide intervention) April 8 & 9/09 8:30 a.m. - 4:30 p.m. $175 February 27/09
ASIST (suicide intervention) May 14 & 15/09 8:30 a.m. - 4:30 p.m. $175 April 3/09
ASIST (suicide intervention) July 16 & 17/09 8:30 a.m. - 4:30 p.m. $175  
ASIST (suicide intervention) Oct 1 & 2/09 8:30 a.m. - 4:30 p.m. $175  
ASIST (suicide intervention) Nov 25 & 26/09 8:30 a.m. - 4:30 p.m. $175  
ASIST (suicide intervention) Mar 4 & 5/10 8:30 a.m. - 4:30 p.m. $175  
 
 
Applicable Discounts
Check the appropriate box!  Limited spots available at discounted rates (maximum of five (5) and two (2) spots for students and consumers, respectively). 
Student I.D. required.  
Event Title F vs. F ASIST H.Skills MHWrks. Mental Health For Life

If you
require any accommodations,
please let us know at time of
registration.  No lunch provided.
*CMHA/Peel Members free $175 $100 $230 free
Students not offered $100 $80 $230 n/a
Consumers not offered $40 $40 $230 n/a
 
Participant Information
Company 
Name  Title
Department  Fax
Street  Ph./Cell
City  Postal Code Email
Name as to Appear on Certificate 
 
Payment Details
Full Fees   Applicable Discount   Owing    
Method      
Chq.  If paying by cheque make it payable to CMHA/Peel Branch and mail to:
CMHA/Peel Resource Centre, 2 County Court Blvd., Unit 102, Brampton, ON L6W 3W8Ph. 905-451-2123		  
Visa  If paying by Visa, please call CMHA/Peel Resource Centre at Ph. 905-451-2123 with Visa number
M/C  If paying by MasterCard, please call CMHA/Peel Resource Centre at Ph. 905-451-2123 with MasterCard number
Cancellation Policy
Refunds available up to and including the registration deadline less a $25 administration fee.  A substitute may attend, but only one person may occupy the spot.  Deposits may be required for group bookings and are non-refundable.  CMHA/Peel reserves to right to cancel a session due to insufficient registration.
 

More workshops available - book for a group at your site or in our training room!

 

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