Session Registration Form

Please complete this form to register for one of our Learning Circle or Aboriginal Youth Learning Circle sessions.

**NOTE: If you are attending by health authority video conference, you must complete and submit the PHSA Bridge Booking Request Form (in addition to this registration form) no later than 48 hours prior to your chosen session**

Name*
Title/Role*
Email*
Your Location / Organization*
Phone*
Session(s) you would like to attend (You may select more than one session):*
May 27, 2013 (9:00 – 11:30 a.m. PST) Ktunaxa Self-Development and Self-Determination: Traditional Knowledge, Colonial Experiences and Ktunaxa Knowledge Relationships - Joe Pierre Jr. & Michele A. Sam
May 27, 2013 (12:30 – 1:00 p.m. PST) Ktunaxa Self-Development: Traditional Knowledge and Colonial Experiences - Gwen Phillips
May 27, 2013 (1:15 – 3:30 p.m. PST) Introductions to Guest Panel: Overview of Presentations - Dr. Tom Boyce, Dr. Michael Kobor, Michele A. Sam
May 29, 2013 (1:00 - 3:00 p.m.PST) UBC Centre of Excellence in Indigenous Health & the Cedar Project Partnership

How do you plan to connect with us? *SELECT ONLY ONE OPTION**
Video conference
Computer webinar ('Adobe Connect')
What's the difference between video conference and computer webinar? Click here to find out!
Type the TWO words into the box below (just to make sure you are a human).

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