Counselor
LCSW Practice

Available CD's

Biography

Contact Deb

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