Please register for this event by filling out the form below.

You can submit this form for secure online processing, or print off for faxing/mailing to our office:

Rural Ontario Institute
5653 Highway 6 North
RR#5
Guelph ON
N1H 6J2

Phone: (519) 826-4204
Fax: (519) 826-4208
Email: info@stepstoleadership.ca

Important Note for Online Applicants:

Have you received a "Your transaction has not been completed. Please modify your information below" error? This confirms that your Application has NOT been submitted and received by ROI. Review the form as some fields may have been skipped or filled with an invalid format. Please telephone (519-826-4204) or email (info@ruralontarioinstitute.ca) right away and we will be happy to help you.

You will receive personal confirmation from the office, within 48 hours, that your application has been received. If you do not hear from us, please call or email.

Event/Seminar Information

Event/Seminar Name
Start Date
Price (CAD) $ 
HST (CAD) $ 
Total (CAD) $ 

General Information

First Name:  
Last Name:  
Address 1:  
Address 2:
Town/City:  
Postal Code:  
Home Phone:
(format xxx-xxx-xxxx)
Cell Phone :
(format xxx-xxx-xxxx)
Email Address:
   
Business/Organization :
Position Held :
 
Please answer the following questions
* please note there is a character limit of 800
 
How do you anticipate applying the leadership skills you will learn and strengthen as a result of participating in this program? :
List the leadership training opportunities (workshops, courses, seminars) in which you have participated
Do you require any special services?
Will you be applying for Travel/tuition assistance:  

Payment Options

Method of Payment:  
Name on Card:
Card Number:  
Expiry: / (mm/yyyy)    



If you are under 18 years of age please have a parent or guardian download, print and sign the Authorization and Commitment form and mail or fax to:

Rural Ontario Institute
5653 Highway 6 North
RR#5
Guelph ON
N1H 6J2
Phone: (519) 826-4204
Fax: (519) 826-4208
Email: info@stepstoleadership.ca

I have read the authorization and commitment form and agree to all terms and conditions