Authorization to post information
Please print and complete the following form and sent it by mail to Geneviève Lévesque to one of these addresses:
184 Lake Promenade
414 - 1800 14a Street S.W.
I authorize you to post on the Virtual Resources Center of website www.CapitalDocumentation.ca the biography which I sent you at email info@CapitalDocumentation.ca .
I also authorize you to post my photo :
___ which I sent you by email ;
___ which I am hereby sending to you by mail (please return it to me after scanning it);
___ which you can download from the following website : ________________________________
Please find herewith a cheque (made to Geneviève Lévesque) for one hundred dollars for posting my information in English in the Virtual Resources Center and/or in French in the Centre virtuel de resources.
Name : ___________________________
Street : ____________________________
City : _____________________________
Province : ___________
Postal code : _____________
Phone : _________________________
Fax : ________________________
Signed on ___________________
Last Update : 2010-05-24