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