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Veteran Women Health and Wellness Day
Please RSVP to attend this event. All blocks must be filled. Your personal information is to specifically tailor this event to your fields and will not be disclosed to other organizations.
Date: Saturday, January 26, 2019
Time: 9:00 am to 2:00 pm
Address: 2520 S. Western Ave., Chicago IL 60608
Email Address *
Your answer
Do you have verification as a veteran? *
Are you registered in *
Your Full Name *
Your answer
Your Address *
Your answer
Your Phone Number
Your answer
Services that will be offered at this event
New! Medical / Dentistry may be offered to your children age 5-13. Must be pre-registered.
If "yes" above, how many children, name, gender and age:
Your answer
Do you need childcare?
List giveaways suggestions or special needs here:
Your answer
Do you plan to attend the event? *
Do you need special accommodations? *
Will you be riding our bus to the event? Location for transportation is: B R Ryall YMCA, Northwestern DuPage, 49 Deicke Dr., Glen Ellen, IL 60137 at 7:30 a.m.
If yes, will you have a children with you, and how many?
Your answer
If "yes' above, please explain:
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