B a s i c s o f G e o l o g y, M i n i n g a n d Mineral Processing for the Investment Community September 26&27,2010 Registration First Name: Last Name: Company: Address 1: Address 2: City: State/Province: Postal Code Country Email Address Contact Phone Number What area(s) is (are) of interest to you?
Visa MasterCard Method of Payment: Cheque (Please make cheques payable to Queen’s University) Bank Transfer
For Credit Card Use: Card Number:
Expiry:
Signed: Date:
**PLEASE FAX TO KATE AT 613-533-6597**