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Guest Lecturer Form - GUEST FORM

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									                             GUEST FORM
Date:

Course Name and Number:

Instructor:

Guest’s Name:

Birth Date (REQUIRED):

Address:

City:                        Province:      Postal Code:

Telephone Number: (      )

Social Insurance Number (REQUIRED):

Current Citizenship:

Date of Visit:

Time:                              Place:

Purpose of Visit:

Description:




Please note:
 Honorarium payment of $100 per course, per year from the AIF.
   This payment WILL NOT be processed unless this form is completed
   in full.
 Payments will be sent to the guest AFTER their visit to York
   University.
 Campus maps are available to fax or send to our guests.




                                                           7/19/2011

								
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