ONLINE CREDIT CARD REGISTRATION FORM FOR INTENSIVE TOILETING WORKSHOP : PROMOTING INDEPENDENT TOILETING ACROSS THE SPECTRUM -
June 9, 2010
Time: 10am to 12pm
Location: The Elija House 665 N Newbridge Rd Levittown NY 11756
FEE: $20 PER Elija Member OR $30 Non Member or $40 if LATE OR WALK IN FEE AFTER June 3 2010

YOU CAN ALSO PAY BY CHECK/MONEY ORDER OR CREDIT CARD VIA MAIL CLICK HERE

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Last Name
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Registration fee 20 Elija Members $30 Non Members $40 Late or Walkin if after June 3rd 2010
Total to be charged
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