CANSW Application

CANSW Conference Registration
40th Annual CANSW Conference

“Resilience: Retreat,
Restore, Rejuvenate”

40th Annual CANSW Conference
2018 CANSW Conference

October 11th-12th 2018
YMCA Geneva Park
Orillia Ontario

Please note rooms can be single or double occupancy, though rate is the same regardless.
Accommodation rate includes all meals and snacks.
In honour of our 40th anniversary, conference rate also includes ONE complimentary therapeutic treatment during the conference.

Name *
E-mail Address: *
Institution *
Phone *
Fax
CANSW Members Before Sept. 7, 2018 After Sept. 7, 2018
CANSW Members Conference Rate
Non CANSW Members Before Sept. 7, 2018 After Sept. 7, 2018
CANSW Non Members Conference Rate
Students
Accommodations
Please Indicate Any Dietary Restrictions
Payment Method * You will be redirected to payment upon clicking the "Submit Button" Paypal Cheque E-transfer
Total
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Enter Verification Code: *
If you are paying via PayPal please choose the appropriate payment after completing the online application and clicking the submit button. All payments will be checked with online application submission dates for accuracy of payments received.	If you are paying via cheque please submit a copy of the confirmation email you will receive after completing the online application.
Use this email address for all e-transfers
etransfer@cansw.org Please place your Full Name in the comment section of the transfer to synchronize payments with Registrations (Use your last name as the security password with capital letters where applicable)
In accordance with CANSW's Privacy Policy,by submitting this form,I understand that my information will be posted on the Members Only section of the CANSW web site and can be accessed only by other members of CANSW. Information will never be shared with other organizations without prior and explicit consent of the members. *Please contact the CANSW President should you wish to alter personal information or have further questions.


* Required

FOR MORE INFORMATION ON THIS CONFERENCE YOU MAY CONTACT Gordon Smith at 780-735-9608 or email at Gordon.Smith@ahs.ca