"Striving to make women healthy" - GALA REGISTRATION
HEALTH & FITNESS 4 MINORITY WOMEN INC. - "Striving to make women healthy"
 
Gala Registration Form
 
To resgister please fill out this form
Health & Fitness 4 Minority Women, Inc. *
Buy your tickets online by pushing the "Pay now" button
 
Gala Registration Form
Name/Company's Name:
Address/City/State/Zip:
Contact Number:
Email Address:
Please check the appropriate box:
Group rate (10 persons) $45 per person
Employers Discount (10 persons) $50 per person
Community Advocates for HF4W Inc $50 per person
Low-income Minority Women $30 per person/$25 group
Individual Cost $50 per person
For Groups Please list the names of your members
Please enter the number of Persons
Please enter the amount registered:
For Checks Please mail your registration to:
Health & Fitness 4 Minority Women, Inc
Attn: Health Education/Prevention Programs
7118 Orral street, Oakland CA  94621