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REGISTER

Course Registration Form for CIIAN's ADR Certificate Program (Modules I to III & our Special One Day Workshops)

Participants can register by phone, fax, e-mail or post. These registration forms can be downloaded (in Microsoft word format) here. You may also print this page and fill-in the form by hand.

For our Online Negotiation Training please use this form Online Negotiation Training.

For our Leadership Training Program please use the form on the Leadership Training page.

Phone: 1-613-237-9050

Fax: 1-613-432-6951

E-mail: ciian@ciian.org

Post:

CIIAN
97 Tom's Road
R.R.#1
Dacre, ON
K0J 1N0

 

Canadian International Institute of Applied Negotiation

Registration Form

ADR Certificate Program & Modules I, II, and III

Register today: (1) Online;  (2) By Mail;  (3) By Fax; or (4) By Telephone

Please address all my correspondence to my Home  or Office as follows:

NAME (Please Print)                                                                   

(As it will appear on certificates)

TITLE:

SECTION:

COMPANY/DEPT:

MAILING ADDRESS:

CITY:        

PROVINCE:                                                              POSTAL CODE:

TEL HOME:                                                               TEL WORK:

FAX:                                                               EMAIL:

How did you hear about our courses?

Have you taken CIIAN courses before?      YES             NO

Do you have any other non-CIIAN training in ADR, NEGOTIATION OR MEDIATION?

  YES             NO

If yes, please indicate where:

Registration Fee: Your registration fee covers the selected module and all course materials.

Corporate Discount Rate: A $50.00 discount per person is available when 3 or more people attend the same course from the same Organization.

Cancellation Policy: A cancellation made later than one week prior to a course will be subject to 50% of the course fee. Cancellations made earlier than one week prior to a course will be subject to a $75.00 Administration Fee.

We reserve the right to cancel an upcoming course should there be insufficient enrolments. While all reasonable efforts will be made to notify course participants in a timely manner should a course need to be canceled, we will not be held liable for any costs whatsoever incurred whether direct or indirect by participants should such a course cancelation need to be made.

PAYMENT OF REGISTRATION FEES

OTTAWA COURSE FEES

SELECTION (please indicate date and module choice)

*Module I

$2,200 + $110 GST = $2,310

Tuesday August 17 - Friday August 20, 2010 (Ottawa)

Tuesday September 28 - Friday October 01, 2010 (Toronto)

Monday February 21 - Thursday February 24, 2011 (Ottawa) 

Tuesday August 16 - Friday August 19, 2011 (Ottawa)

 

 

 

 

*Module II

$2,200 + $110 GST = $2,310

Monday August 23 - Thursday August 26, 2010 (Ottawa)

Monday February 07 - Thursday February 10, 2011 (Toronto)

Monday March 21 - Thursday March 24, 2011 (Ottawa)

Monday August 22 - Thursday August 25, 2011 (Ottawa)
 

 

Module III

$1,950 + $97.50.00 GST = $2047.50

Monday November 8 - Thursday November 11, 2010 (Ottawa)

Monday October 17 - Thursday October 20, 2011 (Ottawa)

 

 

Special Programs

Priced Accordingly

 

 

*Modules I & II: Completion of both Modules has been accepted as an Approved Mediation course by the ADR Institute of Ontario Inc. 

 

All courses are approved for Federal Income Tax Deduction. Do you wish to have a tax receipt issued? 

  YES             NO

Payment Method

Please invoice my employer.  Billing information as follows:

 

Company:

 

Attention/Reference:

 

Address:

 

City/Province:

 

Postal Code:

 

My cheque or money order is attached (made payable to CIIAN)

Registration closes two weeks prior to each course. Early registration will help ensure a place.  Please return this completed form with payment to:

CIIAN
97 Tom's Road
R.R. #1
Dacre, ON
K0J 1N0