Please note you have the option of attending either the morning program with our keynote speaker or both the morning and afternoon sessions which will include the breakout discussions with local survivors. Since space is limited, we will fill our spaces on a first come, first served basis. Registration for both the morning and afternoon sessions will be cut off at 1200. The seating capacity for the morning is 2000. There will be a reduced fee of $5 for those attending in the morning only.

Please make cheque payable to: Jewish Heritage Centre of Western Canada
Please mail payment by February 28, 2012 to:
Holocaust Symposium 2012, Attention: Roberta Malam
c/o Jewish Heritage Centre of Western Canada
C140-123 Doncaster Street Winnipeg, MB R3N 2B2

Upon receipt of this form and the registration fees you will receive notice of confirmation.

For further information please contact Roberta Malam at the Jewish Heritage Centre, at 477-7460 or by email: holocaustsymposium2011@gmail.com

	Yes, my school will attend the Holocaust Symposium on Wednesday, May 16, 2012 at the University of Winnipeg Duckworth Centre.
	Morning & afternoon Morning only

The following number of students will attend:
Grade 9:	Grade 10:	Grade 11:	Grade 12:

Please list the names of teachers who will be accompanying the students:

General Information
Contact name (s):
School:
Address:
Telephone:	( ) -
Fax:	( ) -
E-mail Address:

Fee Information
Both sessions:	$7.00 x (no. of students) =
Morning only:	$5.00 x (no. of students) =