(print form and mail or fax) REGISTRATION FORM (please print) [] Sign me up to participate in a conference on community access to the information highway! Name/Title ................................................. Agency/Organization (if applicable) ........................ Address .................................................... City ............... Province .......... Postal Code ....... Telephone:(w) (.....)............. (h) (.....).............. Fax: (......)............... Email ......................... Registration fees: [] $130.00 + GST Method of payment: [] Cheque (by mail; cheques payable to InfoLink Consultants) [] Mastercard [] VISA Credit Card Number: .............. Expiry date ............. Name of Card Holder: ............................. Signature: ....................................... (A limited number of subsidized spaces are available for students/unemployed/limited income. Call for information.) Please indicate any special needs we should be aware of: [] Physical challenges (please specify) .................... [] Food Allergies (please specify) ......................... [] Other ................................................... What Internet applications/uses are you interested in exploring in tutorials? [] Logging on [] Email/Usenet [] Gopher/Veronica [] FTP/Archie [] World Wide Web [] Other (specify) ................................... * Mail completed registration form to: Community Access to the Information Highway c/o InfoLink P.O. Box 4892, Station E Ottawa, ON, K1S 5J1 OR * Fax completed registration form to: 1-613-235-0155 * For more information: 1-800-265-3973 in Ottawa: 594-5960 email John Thurston, ag264@freenet.carleton.ca or Mitchell Beer, ac779@freenet.carleton.ca ___________________________________________________________