Please complete the following form to register for the Provincial Board Meeting, February 2017

Name of Friendship Centre
Name of Voting Director:
Phone:
-
E-mail:
Name of Observer 1:
Observer 1 Phone:
-
Observer 1 e-mail:
Name of Observer 2:
Observer 2 Phone:
-
Observer 2 e-mail:
Name of Elder Delegate
Elder Phone:
-
Elder e-mail:
Name of Youth/PAYC delegate:
Youth Phone:
-
Youth e-mail:
Birthdate:

Registration Fees:  All attendees $100 each - Elder & Youth no charge

Please make cheques payable to:  BCAAFC

Number of attendees:
Total amount due:
Please prove that you're not a robot: