Toronto September 10 & 11, 2011		Toronto November 26 & 27, 2011
	Whistler, BC September 17 & 18, 2011		Vancouver January 14 & 15, 2012
	Calgary October 22 & 23, 2011		Toronto January 28 & 29, 2012

Name of Registrant:____________________________________(please print clearly if faxing)
Title: _______________________ Company/Org Name: __________________________
Street: _____________________________________City: ________________ Prov.: ______
Postal Code: __________ Telephone: ___________ Fax #: _______________
Email: ______________________
Please invoice me personally at my address above.
Please invoice my company. [Please provide details of other billing name and address if applicable.
No, I can't come this time, but please keep me informed about later dates.

Upon receipt of your registration form, we will fax or email back to you a notice of confirmation, and details of location and room. Invoice will follow.

Institute for Quality, Safety and Environmental Management Ltd. (IQSEM Ltd.),
P.O. Box 565, Stn Q, Toronto, ON, M4T 2N4 fax: 416 955-9895, tel: 416 955-9195, info@iqsem.ca

Cancellation and refund policy: Registration fees are refundable only upon written (email) notification 2 weeks prior to seminar date, although rescheduling is OK. IQSEM reserves the right to cancel any seminar as it deems necessary and will, in such event, make a full refund of any registration fee. No liability is assumed by IQSEM for changes in program date, speakers or venue. GST # 870310646.