DIVORCE RECOVERY WORKSHOP REGISTRATION

DIVORCE RECOVERY WORKSHOP REGISTRATION
Spring 2003

PRE-REGISTRATION IS RECOMMENDED.

Please print, fill out, and mail with your $25 registration.

Name______________________________Gender M F

Address_____________________________Age_________

City________________________________Zip__________

Phone (Home)_________________(Work)_____________

Have you completed a workshop before? Yes No

I will be using Child Care facilities: Yes No

List number of children in age group: Newborn-Age 2___ Age 3-Kindergarten___ Age 6-8___ Age8-10___

WORKSHOP FEE: (INCLUDES BOOK) $25.00 *PAY NOW. (PAYMENT GUARANTEES ENROLLMENT)

MAIL FORM ALONG WITH CHECK PAYABLE TO: FIRST UMC OF GOLDEN, 1500 FORD STREET, GOLDEN, COLORADO 80401

FOR FURTHER INFORMATION: CALL 303-279-3484 (Scholarship’s available)