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Registration Form for Workshops

Please print out form & Send with your cheque [S$10-00 per participant or S$35-00 per series of 4 workshops] to  "Breastfeeding Mothers' Support Group (Singapore)" at:  96 Waterloo Street #02-04 SCWO Centre, Singapore 187967
 
 
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: 
 
 

Special Concerns about Breastfeeding you want to know about:
 
 
 
 

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Signature of Workshop Applicant(s)
Date:


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