St. Joseph's at La Providencia Center - Bldg. 4
Return your registration form to:
St. Joseph Renewal Center
1725 Brentwood Road
Brentwood, NY 11717
631-273-1187 x411
Along with your registration form, please make your check out to Sisters of St. Joseph.
NAME:___________________________________________________________________
ADDRESS:________________________________________________________________
PHONE NUMBER:__________________________________________________________
EMAIL ADDRESS:__________________________________________________________
I AM REGISTERING FOR:_____________________________________________________
DATES:___________________________________________________________________
SPECIAL NEEDS, IF ANY:____________________________________________________
REFERRED BY:_____________________________________________________________
DO YOU HAVE A FRIEND YOU WOULD LIKE US TO EMAIL OUR WEBSITE TO. PLEASE PROVIDE THEIR NAME AND EMAIL ADDRESS BELOW.