A Conversation with Dr. Joel Westheimer - REGISTRATION

Thank you for registering for the upcoming presentation - What Kind of Citizen in the Next Alberta? - A Conversation with Dr. Joel Westheimer - on Thursday, November 5 at the Black Knight Inn at 2929 50 Avenue in Red Deer beginning at 6 pm.   We look forward to seeing you there.  Completion of the form will constitute your registration for the event.

* 1. Please indicate your first name.

* 2. Please indicate your last name.

* 3. Please check all that apply

* 4. Please indicate your School Name, District Name, or Organization Name (if applicable)

* 6. Please indicate your preferred email address.

* 7. Please confirm your preferred email address.

* 8. Please indicate if you follow any dietary restrictions or have food allergies of which the event organizers should be aware.

* 9. Please share any questions or comments that you might have at this time.