Activities Form

The questions marked with * are ones you must complete. Otherwise, it is at your discretion what information you would like to have available on the website. Feel free to contact the Centre if you have any further questions or complications, or would like information added to the site that the form below does not request.

*Name of Organisation:

*Contact Person(s):

*Phone Number(s):

Mobile:

Fax Number:

Email Address:

*Please fill in class times where applicable:

Monday	Tuesday	Wednesday

Thursday	Friday	Saturday

Sunday

A short blurb about your program (what you offer, who it's for, about trainers, etc):

Prices/Charges:

Any information you may like to have displayed on the website:

FOR OUR RECORDS:

Do you have a company website?

Yes No

If yes, would you be interested in exchanging links with the OCCYC website?

Yes No

Would you be interested in purchasing additional banner ads in high traffic, relevant and popular locations throughout the website?

Yes No

Any questions: