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Name_______________________________________________________________________________
Address_____________________________________________________________________________
Work
phone_________________________ Home Phone
_____________________________
Cell Phone
_________________________________________________________________
Email
address_______________________________________________________________
Retreat includes two nights
lodging, dinner Friday, 3 meals Saturday, breakfast Sunday, all
snacks, workshops and workshop materials.
_____ $275 double
occupancy - prior attendee or NASW member
_____ $315 single occupancy - prior attendee or NASW member
_____ $285 double occupancy - new attendee
_____ $325 single occupancy - new attendee
Please make check payable to
(sorry, no credit cards
accepted):
Deb Bowen, MSW, LCSW
520 Causeway Drive, Suite B
Wrightsville Beach, NC 28480
Registration must be postmarked by September 29!! Space
is limited to only 40 participants, so register early!
I'm sharing a room with
__________________________________________________
I'm coming alone and would like to be assigned a
roommate_______________________
Note: If your roommate does not attend, or if a roommate
cannot be assigned to you, you will need to pay single occupancy
rate.
Vegetarian meals
requested:________
Food allergies or special needs:
___________________________________________
Confirmation letter with driving directions, packing list and
other information will be EMAILED to you (snail mail if you
don't have email). PLEASE be sure we can read your email
address above!
Questions? (910) 256-9777;
www.deborahbowen.com;
debowen@coastalnet.com
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