Make your own free website on Tripod.com

Sign-Up Form

Breastfeeding Seminar for Health Professionals & Mothers

Please print out form & Send with your cheque [S$10-00 per participant or S$100/- for a group of 11 participants.] to  "Breastfeeding Mothers'  Support Group (Singapore)" at:  96 Waterloo Street #02-04 SCWO Centre, Singapore 187967
 
 
Name:  (Dr/Mr/Miss/Mrs/Ms) 
 
Tel: (Residence)                                 Tel:(Office) 
 
Fax: 
 
Handphone/Pager: 
 
Address:  
 
Email Address:  
 
Are you a BMSG(S) Member?  
 
Amount of Fee Paid:  
 
Type of Application:  Single / Group (10 or more) 
 
Payment (Bank/Cheque No.): 
 
 
 
 

-------------------------------------------------
Signature of Participant
Date:


BACK to News/Events Page

BACK TO BMSG(S) Main Page



Copyright, BMSG (Singapore)