Polarization in Congregations - NOV 2026 | Conrad Grebel University College

Note for multiple registrations on the same payment card:

Provide the number of registrants at the beginning of the form.
Enter first registrant details and the credit card information.
Select Continue.
Once all registrant information is completed, the total fee will be displayed and can be reviewed before finalizing registration and payment transaction.

A unique email address is required for each registrant. (This email will also be used to confirm the Zoom Link).

Online payments are accepted by VISA or Mastercard

How many people are you registering? *

(including yourself)

Workshop Registration

First Name *

Last Name *

Email *

Organization

Position

Street Address *

City *

Country *

Province/State *

Postal/Zip Code *

Phone (Primary)

Phone (Cell)

Workshop Fee *

CMCL WEB Regular Rate (1 person) - $ 67.80

Group Rate (2-5 from the same congregation) - $ 50.85

Group Rate (6+ from the same congregation) - $ 33.90

Total for this participant

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Needs and Preferences

Name (printed on a certificate of completion (FROM LRAC ONLY)

Permission to add to distributed attendee list (name, organization, city & email *

Yes

Additional Requests

e.g. Dietary requirements, accessibility requirements relevant to the workshop delivery mode.

Please contact Certificate Program Manager at 519-885-0220 ext. 24254 or certprog@uwaterloo.ca if you have any questions or if there are any problems applying.