People-Centred eHealth Global Summit The Department of Geography's
50th Anniversary Celebration at York University

Location: York University
Date: Friday October 12, 2012
Registration Deadline: October 11, 2012, 11:59:59 P.M.
Sections marked with "*" are mandatory fields.
PARTICIPANT INFORMATION
Salutation:*  
Last Name:*  
First Name:*  
Address:*  
City:*  
Province or Territory:*  
Country:*  
Postal Code/Zip:*  
Association:

CONTACT NUMBERS *  
Please be sure to provide your email address & phone number so we can contact you with additional information as it becomes available
Home Phone:
Cell Phone:
Business Phone:
E-mail Address: *   

SPECIAL NEEDS
Dietary Needs:

50TH ANNIVERSARY FEE *
Note: *    13% HST is applicable.
*    Prices are listed in Canadian dollars.

 
*   More substantial contributions are very welcome. If you wish to make a larger contribution to the "Friends of York Geography Fund," please contact Amelia Luk: amelial@yorku.ca. Donors giving $250 or more will receive a free copy of "Geography at York University: Reflections on the First Fifty Years."

WITHDRAWAL/REFUND POLICY
If a registrant cancellation/refund request is received in writing more than 2 business days prior to the start date of the event, a refund will be issued for the registration fee less a $10.00 administration charge. We regret that a refund cannot be offered if your cancellation is received less than two business days prior to the celebration dinner. Non-attendance without prior written notice of cancellation will incur the full registration fee.

ADDITIONAL INFORMATION
Additional copies of the "Geography at York University: Reflections on the First Fifty Years" will be available at the registration Desk, (Vari Hall, York University) for $25.00 plus HST, ($28.25);

If you have any questions about ticket purchases please contact Rumina Habib at 416-736-2100 ext. 44617 or by email at ruminah@yorku.ca