Contest Registration Form Contest Category: Quit 4 Good Keep The Count Party Without the Smoke Don’t Start & Win First name: Last name: Phone (1): – ext. Phone (2): – ext. Email Address: Confirm Email Address: Gender: Female Male Other Age: What school do you attend?: Algoma UniversityAlgonquin CollegeBoreal CollegeBrock UniversityCambrian CollegeCanadore CollegeCarleton UniversityCentennial CollegeConestoga CollegeConfederation CollegeDurham CollegeFanshawe CollegeFleming College: FrostFleming College: SutherlandGeorge Brown College: Casa LomaGeorge Brown College: St. JamesGeorgian CollegeHumber College: LakeshoreHumber College: NorthLa Cité collégialeLakehead University: MainLakehead University: OrilliaLambton CollegeLaurentian UniversityLoyalist CollegeMcMaster UniversityMohawk CollegeNiagara College: NOTLNiagara College: WellandNipissing UniversityNorthern CollegeOntario College of Art & DesignQueen’s UniversityRyerson UniversitySault CollegeSeneca CollegeSheridan College: DavisSheridan College: Trafalgar RoadSt. Clair College: ChathamSt. Clair College: WindsorSt. Lawrence CollegeTrent UniversityUniversity of GuelphUniversity of Ontario Institute of TechnologyUniversity of OttawaUniversity of Toronto: MississaugaUniversity of Toronto: ScarboroughUniversity of Toronto: St. GeorgeUniversity of WaterlooUniversity of Western OntarioUniversity of WindsorWilfrid Laurier University: BrantfordWilfrid Laurier University: MainYork University: GlendonYork University: KeeleOther If other, please specifiy: Student ID number: Your Buddy Info First name: Last name: Email Address: Confirm Email Address: Does your buddy smoke? Yes No Is your buddy also registered as a contestant in the wouldurather… contest? Yes No Contest
