Registration

Due to a warm response from interested delegates, the conference is full. Please fill out the registration below only if you would like to be placed on the waiting list. You will only be contacted if an opening occurs.
Thank you for your interest in Quest.

Your Information

Required information is indicated in bold.

First Name

Middle Name

Last Name

Address

City

Province

Postal Code

Area Code

Phone (home)

Phone (office)

Fax

Email

Current Employer (optional)

Job Title (optional)

Are you a graduate of:

The University of Winnipeg (includes United College and Wesley College)

Yes

No

Year(s)

Program:

The Division of Continuing Education

Yes

No

Diploma(s) or Certificate(s)

Year(s)

Program:

The Collegiate

Yes

No

Year(s)

Thank you for your interest in Quest.

Yes - Please add my name to the waiting list

Special Requirements:
The University of Winnipeg OmniTRAX/Broe Quest Series is handicapped accessible. ASL-English interpretation is available on request.