Escolar Documentos
Profissional Documentos
Cultura Documentos
COUNCIL
for caring communities
PHONE EMAIL
LUNCH CHOICE: ❑ Fish ❑ Chicken ❑ Vegetarian Mail or fax this form back to the Council at 617-428-1533
Member Registration Fee: $65 Non-member registration fee for lunch and seminar: $95 Make checks payable to MA Council of Human Service Providers, Inc.
Payment type: ❑ Check ❑ Visa ❑ Mastercard Payment amount: $______ Mail to 250 Summer St., Ste. 237, Boston, MA 02210
Account Number: ___________________________________ Expiration: _____________________________
Name on card: _____________________________________ Signature: ______________________________
You can also register electronically and pay online! Visit providers.org for more information.
Special accommodations needed? Call Sara Morrison Neil at 617-428-3637 before March 19th and we’ll be happy to accommodate you.