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Ontario Department of Agriculture 



WOMEN'S INSTITUTES 



Application for Special Course of Lectures 1913-14 



Name of Institute 



Course chosen (Cooking, Home Nursing, or Sewing) 



(make X through the Course chosen) 

 Number who have definitely promised to take advantage of the Course, if arranged 

 for 



Number of additional persons who will probably take advantage of the full Course 



Probable number who will take advantage of occasional lectures 

 Prospects for class of school girls 



Place where regular class will be held . . . 

 Place where school girls' class will be held 

 Day of week preferred 



Accommodation for board and lodging for demonstrator 



Time chosen for Course, October 6th to December 13th 



January 5th to March 14th . . 



March 16th to May 23rd 



(make X opposite time preferred) 

 Remarks 



Branch President 



Branch Secretary 



Place 



Date 



Note This form to be filled in and forwarded to the District Secretary or Geo. A. Putnam, Su- 

 perintendent of Institutes, Parliament Buildingrs, Toronto, Ont. at as early a date as possible 

 If application is sent direct to the Department, the District Secretary should be notified. 



