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Workshop and Seminar Secure Registration Form

Complete descriptions of each workshop or seminar, including content, process, dates, locations, and fees are available on our Seminar List page.


REGISTRATION BY PHONE, MAIL OR FAX
  • Call 1-800-567-3700 (PST) during normal business hours. (The time right now where we are located is: Friday, 03-Feb-2012 19:07:01 PST)

  • From outside of Canada, call 1-250-595-3503

  • To register by mail, print and send this registration form to:
    Peer Resources
    1052 Davie Street
    Victoria, British Columbia V8S 4E3

  • Or fax the information to 1 (250) 595-3504

REGISTRATION ON-LINE
To register for an upcoming session using our on-line form:

  1. Select from the list of workshops listed below;
  2. Fill out the text boxes with your name, e-mail, and snail mail address;
  3. Let us know if you have any special needs so we can insure the training site is appropriate for you;
  4. Indicate your method of payment;
  5. Let us know if you intend to implement a program with a particular client group; and
  6. Click the send button when you are done

When we receive your registration, we will send you a confirmation letter along with details about accommodation, the training site, a location map, and a receipt for your payment.

SELECT THE SPECIFIC WORKSHOP
Listed in chronological order:

COMPLETE THIS SECURE REGISTRATION FORM
Concerned about sending personal or financial information over the internet? Read our privacy statement.

Name

Job Title (if applicable)

Organization (if applicable)

Department (if applicable)

Street

City

Prov/State

Postal/Zip Code

Is this address:

Work

Home

 E-mail address:

Phone (Day)

Phone (Home)

Cell/Mobile

Fax

Payment Method:

Credit Card

Cheque

Bill Me

Fee Amount:


Credit Card Information: This is a secure form. The transmission of this information is accomplished with maximum encryption and the highest security level. We do not store credit card information on our computers. It is impossible for anyone to retreive this information.

Number
Expiry
Name on card


PLEASE LET US KNOW IF YOU HAVE ANY SPECIAL NEEDS
This information will help us prepare the access and lighting of the training room and take into account any food allergies, etc)

PLEASE INDICATE YOUR PRIMARY INTEREST AREA(s):This information will help us prepare your customized training binder




*Refund Policy for Peer Resources Workshops and Seminars*
If you cancel with at least 20 working days notice, you will receive a complete refund. If you cancel with less than 20 days notice, let us know as soon as possible. If we are able to replace your seat in the workshop or seminar, you will receive a full refund. If we are unable to replace your seat, your registration fee is forfeited.

Peer Resources | Mentors | Coaching | Contact