The Ontario Health Coalition Presents a
HEALTH
ACTION
ASSEMBLY

We have a new government–it’s time to:

Saturday November 22, 2003
Sheraton Centre, Toronto
9 a.m.-10 a.m. Registration
10 a.m.-5 p.m. Assembly


Registration Form — Health Action Assembly, Saturday, November 22

Contact Name:

Organization:

Contact Address: Number of people attending:

(Please add any additional names):

City/Province: Postal Code:

Phone (daytime): Phone (evening): Fax: E-mail:

Registration fee ($0-$35 per person, pay-what-you-can) collected to help offset costs of meeting. As soon as you register,
we will be sending you a full assembly kit. Please send your form to:

Ontario Health Coalition, 15 Gervais Drive, Suite 305, Toronto, Ontario, M3C 1Y8

Fax: 416-441-4073 E-mail: ohc@sympatico.ca Phone: 416-441-2502

For Office Use Only

Kit Sent
Added to mail list
Added to e-mail