Women's Rural Resource Centre of Strathroy and Area

I.Q. Challenge Registration

For a printable I.Q. Challenge Registration Form (PDF), click here. You can send the completed form by fax to (519) 246-1422 or mail to:

145 Beech Street
Strathroy Ontario
N7G 1K9

Note: If you do not have Adobe Acrobat Reader, please click on the link to download it for free.

I.Q. Challenge Registration Form
Online Form Submission

Date:
Team captain:
Team name:
Address:
City:
Province:
Postal Code:
Phone:
Company:


Team Members
Team Captain's Name:
Email:

Team Member's Name:
Email:

Team Member's Name:
Email:

Team Member's Name:
Email:

Team Member's Name:
Email:

Team Member's Name:
Email:

Team Member's Name:
Email:

Team Member's Name:
Email:

Please select:

Yes! We will enter a team for $200 (up to eight players).

Yes! We will become a Sponsor at the Level (e.g. Platinum, Gold, Silver, Bronze).

Yes! We will donate an auction item (item description attached).

Yes! We/I would like to make a donation to the Women’s Rural Resource Centre.

Comments:

To reserve your table:
Please submit this form along with sending your payment to:
Women’s Rural Resource Centre
145 Beech Street
Strathroy, Ontario
N7G 1K9