Date:  	
Course Name:	Course Location:	
Student’s Name:	Student’s Name:	
Address:	
City:	
Postal Code:	Home Phone:	
Email address:	

Work/Cell Phone:	
	
I found out about the session from: a friend __ radio __ TV __ newspaper ___ website __ 
Other (please specify) ____________________________________________________	
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From time to time, we receive calls from the media to interview or quote past participants.  May we contact you?  Yes ___   No ___	
Signature:                                                                               Date:	

*	
Please call 1-866-696-1666   or 416-648-3624 to reserve your spot and 
then mail this registration form with a cheque payable to: 
The Etiquette Ladies
82 Jarvis St. Orillia, ON L3V 2A3
Or make payment through PayPal

For Office Use
Session Date: _____________________		Start time: ___________________

Location: ________________________ 		End time: ___________________

Payment received: _________________ 		Confirmation call complete: _____