Printable Registration Form

 

If you prefer to mail-in your Workshop Registration simply print this page and complete the below fields.

Mail completed form to Brenda J. Hayes, 123 East Main St., Fredonia, NY 14063

Name: ___________________________________________

Phone: ___________________________________________

Address: _________________________________________

Email: ___________________________________________

Check those you will be attending:

[___] Winter 2014: Becoming a More Positive Thinker ($20)

[___] Winter 2014: Empowering Ourselves to Reach Our Own Personal Best ($20)

[___] Winter 2014: Living Alone: From Challenge To Opportunity ($20)

[___] Winter 2014: The Role of Caregiver: Keeping Ourselves Balanced ($20)

[___] Gift Certificate: Three (3) sessions of personal coaching ($240)

Total $ ___________

You can also register by email or phone. Contact Brenda Hayes:

  • Email: brendahayes@fairpoint.net
  • Phone: 716-785-3555

____

Click here for more information and dates for current Workshops

 

© 2011 brendajhayesphd.com Suffusion theme by Sayontan Sinha