『希望之心安寧醫護關懷中心』全美免付費電話會議式重症疾病教育講座,每個月第三個星期四晚上6-7時(太平洋時間)舉行。
網上報名表(請確實登記,以便我們能夠順利地提供講座當天所使用的免付費電話號碼和講義並郵寄『希望心園』季刊)
Email address *
請填英文姓名 English Name *
Your answer
請填中文姓名 Chinese Name
Your answer
請填地址 Home Address *
Your answer
城市 City *
Your answer
州 State *
Example: CA
Your answer
郵遞區號 Zip *
Your answer
請填電話號碼 Telephone Number *
Your answer
參加講座日期 Date Attending *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms