FM 90.5 - Peterborough 
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Community Club Awards Registration Form 

   

Registration Form
FM 90.5 Peterborough Community Club Awards

For more information, contact FM 90.5 CCA Director Kathy Farley at
705-874-0905 or kfarley@fm905.ca 
Organization/Club:
Your First & Last Name:
Your Position With Organization:
E-mail:
Phone #1:
Phone #2:
Address (specify Unit/Suite/Apt.):
Address (Number and Street, etc.):
City/Town:
Province:
Postal Code:
 
Your Organization's CCA Chair Person:
E-mail:
Phone #1:
Phone #2:
Address (specify Unit/Suite/Apt.):
Address (Number and Street, etc.):
City/Town:
Province:
Postal Code:
Number of Members:
Number of Buyer's Guides Required:
Comments:

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