Date : Dimanche le 9 novembre 2014 / Sunday November 9, 2014. Frais d'inscription 20$ par participant / Registration fee 20$ per participant. Inscriptions des ...
FORMULAIRE D’INSCRIPTION REGISTRATION FORM Accompagnez-nous dans cette édition de
La marche HGJ d’Hypertension Pulmonaire Centre Y Centre-ville 1440 rue Stanley, Montréal, H3A 1P7
Please join us in this year’s
JGH Pulmonary Hypertension Walk Downtown Y Centre 1440 Stanley, Montreal, H3A 1P7
Date : Dimanche le 9 novembre 2014 / Sunday November 9, 2014 Frais d’inscription 20$ par participant / Registration fee 20$ per participant Inscriptions des 12:00 / Registration begins at 12:00 pm Marche débutera à 13:00 / Walk begins at 1:00 pm ………………………………………………………………………………… Montant / Amount $__________________ Nom/Name: Adresse/ Address: Tél. (bur./office):
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Code postal/ Postal Code: Tél. (rés./home):
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Courriel/Email: Cash *Chèque ci-joint au montant de/*Cheque enclosed in the amount of MasterCard
Visa
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*Payable à
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Signature : Un reçu officiel sera émis par la Fondation de l’Hôpital général juif A tax receipt will issued by the Jewish General Hospital Foundation
t Check payable to « ITO - colloque» t Bank transfer IBAN FR76 3000 3035 0100 0501 2961 754. BIC. SOGEFRPP. Please return this form with your payment to:.
7â25 July 2003. Aix-en-Provence, France. PARTICIPANT REGISTRATION FORM. Please return this completed form before February .... Place of birth, country.
4 to 6 years, Monday to Friday (9:00 am â 5:00 pm). 4 à 6 ans, lundi au vendredi (9h00 â 17h00). 1st week: from 29th June to 3rd July. 1ère semaine : du 29 juin ...
I give my consent for Les Petits Grands Lecteurs to take my child in photo or video for advertising reasons related to youth programs (eg, leisure guide). *. I Oui.
Sun Yoga India workshop ⢠level 2 (advanced) in France from August 6th ... http://info-ler.fr/upload/ficheshoraires/web2016/FH_LER_26.pdf). The station is ... Please let us know in advance if ... If you arrive on the beginning day (on the 6th) :.
This certificate remains the property of SAI Global and must be returned to them upon request. To verify ... CHANGE IN MANUFACTURER'S ADDRESS. Reason ...
B. VEHICLE INFORMATION (If more than one vehicle, use a Vehicle Reading form che descriptive for every other vehicle.) Year: Make: Model: Color: Body: Series/Trim: # VIN: Odometer: KMS. MILES. Distance Travelled Unknown. Please explain (select most a
Jan 15, 2009 - Please ensure that your bank covers any transfer charges. Please make checks payable to S.O.O.N. [Design Research Foundation]:. S.O.O.N..
Altertour Individual Registration Form .... 3. a copy of your Civil Responsibility insurance ; ... o Children stay under the responsibility of their referent adult.
6 oct. 2017 - liter le parcours des gens qui ont choisi l'activité physique comme premier ... Julie-Christine enseigne en techniques d'éducation spécialisée au Cégep de ... Autant dans son parcours professionnel que sportif, elle privilégie la .... S
Deadline to register: Friday, May 18. Date limite pour inscrire: vendredi, 18 mai. Note: Members who are single parents, parents attending Congress on their own ...
1. Personal Information (the fields marked with * must be completed). * Title. * Name: * First name: Organisation/Company: Organisation type (please stick one):.
