Katrina
On 25/09/2005, at 5:04 PM, brendamanning wrote:
‘Facilitating Instinctive Birth’
Workshop with Lina Clerke
Registration form
<x-tad-bigger>I need this completed & returned for definite numbers.</x-tad-bigger>
<x-tad-smaller>Name _______________________________________________</x-tad-smaller>
<x-tad-smaller> Address ____________________________________________</x-tad-smaller>
<x-tad-smaller> ______________________ postcode ____________________</x-tad-smaller>
<x-tad-smaller> Phone number</x-tad-smaller><x-tad-smaller> __</x-tad-smaller><x-tad-smaller>________________________________</x-tad-smaller>
<x-tad-smaller> E-mail _____________________________________________</x-tad-smaller>
<x-tad-smaller> </x-tad-smaller>
<x-tad-bigger>Workshop date:19</x-tad-bigger>th<x-tad-bigger>October 2005 Time: 09:30hrs to 16:00hrs </x-tad-bigger>
Venue: Rosebud Hospital
Point Nepean Rd
Rosebud. 3939.
<x-tad-smaller>Profession _____________________</x-tad-smaller>
<x-tad-smaller>How did you find out about the workshop? ____________</x-tad-smaller>
BYO LUNCH<x-tad-bigger> </x-tad-bigger>
<x-tad-bigger>Students: $20 Visitors: $50</x-tad-bigger><x-tad-bigger> Peninsula Health Employees: No Cost</x-tad-bigger>
<x-tad-smaller>Amount paid _________ </x-tad-smaller>
Please make <x-tad-bigger>Cheque / Money Order </x-tad-bigger>
payable to: ‘<x-tad-bigger>the midwife</x-tad-bigger>
’ and send with this form to:
Brenda Manning
79 Besgrove Street
Rosebud. 3939
p/f: 03 59 862535
[EMAIL PROTECTED]
<x-tad-bigger>OR email form & Direct Credit fee via Netbank to: A/C No: 063540 10359680 </x-tad-bigger>
<x-tad-bigger> </x-tad-bigger>
<x-tad-bigger>You will receive a receipt (by mail or email ) which you need to present on the day as verification of booking & payment.</x-tad-bigger>
<x-tad-bigger>Thank you & we will look forward to seeing you there for a great day !!</x-tad-bigger>
Brenda Manning
www.themidwife.com.au
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