Anxiety/Depression Group for Adults

Coping with COVID
Wednesdays, 7:00 - 8pm via Zoom
5 Weekly Sessions beginning May 5, 2021
Number of participants you are registering *
Your Name *

First Name Last Name
Additional Participant (if applicable)

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Alt Phone Number
Email *
How did you hear about the workshop?

Friend or colleague Search Engine Pastor Relative CDPCC website Therapist Other
CHURCH MEMBERSHIP *
If you attend a church not listed, please add it below:
Payment
Note: If you require a scholarship, please contact Donna at 630-752-9750, extension 10 for assistance.
Cost of the Event
Enter amount of payment *

prev next ( X )
USD
Should be Empty:

Payment