Registration for September 26, 2008; February 6, 2009 Retreat for Current CFG Coaches or CFG Members Brookline, MA

Please fill in the form below and press the submit button at the bottom. All Information is required.
First name :
Last name :
Position :
Workplace :
NSRF Membership :	Are you a dues-contributing member of NSRF? Yes No
Address of workplace :	Street City State Zip
Home address :	Street City State Zip
Summer address : (optional) (if different from above)	Street City State Zip
Home phone (include area code)
Work phone (include area code)
Cell phone (Optional)
Email :
Summer Email (Optional)	(if different from above)
Billing Information
Who is Responsible for payment?
Bill to the attention of
Billing Address	Street City State Zip
Billing Phone (include area code)
Billing Fax