Organization:

Address:

Postal Code

Contact:

Phone:

Org.

Personal

Fax:

Org.

Personal

E-Mail:

Please check one of the following:

                                    Community Service                                 Club                                               Business

How many tables do you need?

1

or

2

Do you need electricity?

YES

or

NO

Do you need to back onto the boards?

YES

or

NO

Will you provide a demo?

YES

or

NO

If yes, please describe your demo and length of time needed:

OUR THEME THIS YEAR:

“TO BE DETERMINED”

Fees are to be included with this form.  Cheques payable to:

COLD LAKE COMMUNITY LEARNING CENTRE

Box 8249, Cold Lake, AB T9M 1N2

By Deadline:  Non-Profit - $15 per table                Business - 1^st table $20; 2^nd table $15

After Deadline:  Non-Profit - $20                            Business - 1st table $25; 2nd table $20

This registration can be returned to any of the following:

Cold Lake Community Learning                        1301 – 8 Avenue                                780-639-3134

Cold Lake Energy Centre                                  7825 51 Street                                       780-639-6400

4 Wing Recreation                                              JJ Parr Sports Centre                         780-840-8000 local 8192

Registration Deadline: August 12, 2011