Registration Form

To register for a workshop, please complete and submit the following form. A confirmation of registration and invoice will be sent to you at the email address you provide. To have someone copied on this correspondence, include their email in the additional comments section below. Please allow for 1-2 business days for your registration to be processed.

Privacy Statement: Any information received from CEC workshop registrants is exclusively for CEC administrative purposes and not shared with any outside organization.

Full Name*
First Name Last Name
Select Workshop
Workshop Date

Organization*

Department*

Title*

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number*

- Area Code Phone Number

ext

Fax

- Area Code Phone Number

E-mail*

Additional Information/Comments

How did you find out about us?

Would you like to be added to our mailing list to receive schedule updates ?

yes