Return your registration form to:

St. Joseph Renewal Center

26 South Saxon Avenue

Bay Shore, NY 11706 

Along with your registration form, please submit a $30.00 non-refundable/non-transferable deposit; 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.