Healing the Wounds of Racism
Register Early
Maximum Enrollment is 32
Registration Form
Please Check one:
    • March 13, 2010, HEALER'S SESSION
    • April 9-11, 2010
    • April 11-13, 2010
    • August 9-11, 2010
    • August 13-15, 2010, LEVEL II
    • September 17-19, 2010
    • October22-24, 2010

Name__________________________________________________________________

Address_______________________________________________________________

City, State____________________________________________ZIP____________

Phone (daytime)_____________________Phone(evening)____________________

Email_________________________________________________________________

Church________________________________________________________________

I would like a certificate for Continuing Education Credit: __Yes __No

REGISTRATION FEE:  $200

Amount Enclosed: $________________________

Make checks payable to:
Eastern Pennsylvania Conference (Memo: HWOR) Mail this registration form to: Attn: Rev. Hilda Campbell EPAUMC P.O. Box 820 Valley Forge, PA 19482-0820 SPECIAL NEEDS: Every effort will be made to accomodate dietary or other special needs listed below. Please be specific. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ For further information, see http://www.ppjr.org/ltrain, or contact Rev. Hilda Campbell, hilda.campbell@epaumc.org, 610-666-9090, ext 224, or Warren Tyson, warrent@easterndistrict.org, 267-932-6050.