Workshop Registration Form
$75.00 for affiliated locals, $90 for non-affiliated locals. The registration fee includes course materials, coffee, tea and snacks for breaks and lunch (will include vegetarian option) on Saturday. $50 if member has any other dietary restrictions and will not be participating in lunch.

Please make cheque payable to the Niagara District CUPE Council and mail to:

Susan Schmidt
c/o Niagara Area Office
110A Hannover Drive, Suite 101
St. Catharines, ON L2W 1A4
Name *
Please enter the first and last name of the participant
Your answer
Email Address *
Please enter the email address of the participant.
Your answer
Mailing Address *
Please enter the full mailing address of the participant including postal code
Your answer
Primary Contact Telephone Number *
Your answer
CUPE Local Number *
The number assigned to your Local. ie: CUPE Local XXXX
Your answer
Workshop Registration *
Which workshop would you like to register for?
Required
Payment Confirmation *
Payment will be forwarded within 7 days of registration or space will be released
Required
Special Requests *
Please indicate if you have any allergies, dietary or mobility retrictions.
Your answer
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