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Mail-in Registration Form
name:
address:
 
day ph: eve ph:
email:
Please register me for:
workshop name: workshop date:
   
   
   
   
   
   
   

Unless otherwise indicated, there is no charge for any workshop.
Pre-registration is required.

Please print this registration form, fill out & mail to:

Paths to Wellness
Adelphi Breast Cancer Program
Adelphi University
One South Avenue, PO Box 701
Garden City, NY 11530-9720

Fax to: 516.877.4336 or call 516.877.4325 to register by phone.

Please register as soon as possible, as space and seating is limited.

RETURN TO: Paths to Wellness schedule.

 

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Adelphi NY Statewide Breast Cancer
Hotline & Support Program

All services are free and confidential.