Body Image Registration Form

To register for the “Breaking the Mold, Breaking the Silence: National Conference on Body Image", please complete the form below or print and mail the pdf form.  If you have any questions, please call 902 457-6581 or email  Early registration would be appreciated and is encouraged.  As you will note from the fees we have made the costs to participants as low as possible.


Cheques should be made payable to Mount Saint Vincent University and mailed to:


Mount Saint Vincent University
Attention: Body Image Conference
Nancy’s Chair in Women’s Studies
166 Bedford Highway, Halifax, Nova Scotia B3M 2J6


If you are registering by email at, please mark you subject line “registration”.


Payment can also be made prior to November 4th using VISA or Master Card and mailed to the above address or by calling Mary Lou O’Hara at 902-457-6581 to give card number over the phone.  Payments on November 4th. cash or cheque only.

Body Image Registration Form

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*Note: A group of students may be registered at one time, such as 25 students x $3.00 = $75.00 cheque. We need the contact info only for the person making the registration.

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