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ONLINE lymphedema registration form
Facilitator: Desiree De Spong
When: Tues 29 Oct 2024
Time: 6pm -7pm
Please fill in your details below
Persons name
First name
Last name
Email address
*
We will send a zoom link to your email, please ensure you have downloaded the app prior to date of event.
Cell phone
Home phone
We ask for a small koha for this workshop
Koha
*
$10.00
$20.00
$30.00
Other amount
$
Pay/Donate method
Credit Card
Direct Credit to our bank account
Make deposit to account
060433057736600
Please check the highlighted fields
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