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Workshop Registration Form |
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Registration Form for Workshops Please print out form & Send with your cheque to "Breastfeeding Mothers' Support Group (Singapore)" at: 96 Waterloo Street, SCWO Centre, #02-04, Singapore 187967. Payment will not be refunded unless the Workshop is cancelled.
Name:
| Tel:
| Fax:
| Handphone/Pager:
| Address:
| Email Address:
| Are you a Member?
| Amount of Fee Paid:
| Age of Baby / Expected Date of Delivery:
| Date of Return to Work (if applicable):
| Workshop registering for:
| Dates:
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Workshop Fee | | Member | Non-Member | Single Workshop | $10 | $15 | All 4 Breastfeeding Workshops | $35 | $55 | All 4 Breastfeeding Workshops + Back To Work Workshop | $42 | $65 |
Fee waived for first companion, $5 for second companion. No extra notes will be given to companion. Special Concerns about Breastfeeding you want to know about:
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Signature of Workshop Applicant(s)
Date:
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Registration 