3rd INTERNATIONAL ALL-NATIONS CONVENTION
Winnipeg, Canada

Monday August 11 - Friday August 15 2008

Print this Form (from your browser window)
(Please print clearly/Print all names as you would like them on your nametag)

Name: ______________________________________ Spouse:____________________________________ Children: ____________________________________ _________________________________________
Address: ________________________ _______________________________________________________ City: ____________________________ Prov./state: _______________ Postal (zip) code: _____________
Phone #: __(______)__________________ email: _________________________________________
Total for registration ________

Make cheques payable to ETH&S Canada, I have enclosed my cheque for TOTAL ________
or you may charge my V isa_____ or Mastercard _____
Cardholder name: __________________________________________________________
Card # _________________________________________________ Expiry date ______/ ______

( Questions? Or to call in card info, call the ETH&S Office 204-878-4026)
Signature ____________________________________

If you want to register via email, send us all the pertinent information to
ethscanada@ eth-s.org
or mail to: ETHS Canada
PO Box 419
Ile des Chenes, Manitoba
R0A 0T0

We respect Your Privacy!

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