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"2001: An Arts Odyssey" Application Form

(Please include $25.00 fee with application)



Name:________________________________________________________________________________________________

Address:_____________________________________________________________________________________________
____________________________________________________________________________________________________

Telephone Number:____________________________________________________________________________________

District:

__Abitibi __James Bay __Mattagami __Missinaibi
__The Porcupine __Timmins

Do you require accommodations? __Friday __Saturday

Send completed applications to:

Debbie Lanthier
588 Spooner Drive
Timmins, ON
P4N 4R5

****Deadline for application is January 31, 2001****

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