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PWRC Education Registration Form

1. If you have already spoken with the Education Coordinator and Booked an event, please fill out this form with the time and date of your booked event.

2. Once the Presentation or Booth has been confirmed, an invoice will be sent to you. Please mail in a cheque payable to the Prairie Wildlife Rehabilitation Centre or give it to the presenter at your event.

Primary Contact Name (required)

Contact's Email (required)

Contact's Phone

School Name

School Address

School Phone

School Fax

School City

School Postal Code

Preferred Method of Contact
EmailPhoneFax

Method of Payment
ChequeOther

Event Type
PresentationEducation Booth

Please indicate three dates for which you are available to have the presentations. (In order of preference)

If you have already booked an event with the education coordinator, please include the DATE and TIME.

Grade

Age Group

# of Attendants

Location of Presentation or Booth (ie. gym)

Select Presentation
Babies, Bunnies, BeaksWinter WondersBurrowing UnderMeet the Ambassadors (Pre-K, seniors)Prairie RaptorsWhooo's WhoThe Rabbit and the OwlWild ArtPredator and PreyReading with Raptors & FriendsBurrowing Under

Additional Comments

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