N.E.W. LIFE
Dietitian Training Forum 2009
(DTF)
Pre-registration
TBA
Limited to 6 dietitians for 2009 certification
Mail, e-mail, or fax pre-registration form:
Physical mailing address:
144 Sherry Street
East Islip, New York 11730
(631) 704-6977
e-mail:
newlife@newlifeforhealth.com
fax:
(631) 581-5750
Name __________________________________
Address ________________________________
E-mail _________________________________
ADA Registration # ______________________
Telephone ______________________________
Fax ____________________________________
Please enclose $25 deposit
The remaining $300 payable on first day of DTF
Make checks payable to Diane Preves
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