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.