Building a Positive Self-Esteem Registration Form

Building a Positive Self-Esteem March 6 - May 8, 2012
Your Name:
Address:
City:
P. C.:
Telephone:
Email:

To reserve a space
Please fill in and print this page and mail it with a cheque for $75 payable to:

Self-Esteem Network of Hamilton
1063 King St. West, Suite 302
Hamilton, ON, L8S 4S3