October 2013 Open House Contact Form

Please provide us with some contact information and we will pre-register you for the March 2013 Open House or send you some information by mail if you are not able to attend. Thank you. Privacy Notice: Contact information provided in the registration process will be retained and used by Regis College in accordance with its privacy policy.

Name & Surname: *

Name & Surname

Email: *

Address: *

Enter your Address

City: *

City

Province/State:

Select NA if not applicable

Postal Code: *

Telephone Number:

Country: *

Program of Interest: *

How did you hear about the open house?: *

Area of Interest: *

Your Message: *