Canisius CIS New South Wales - Booking Form

Fill in the details below to register for your retreat/program. Upon receipt of payment your booking will be confirmed. You can call your local Canisius to pay by credit card, or mail your payment. If you have not been contacted within a few days, please check we have received your booking. We look forward to meeting you soon.

Canisius (NSW) 102 Mona Vale Road, Pymble NSW 2073 Email: canisius@cis.jesuit.org.au

Tel: 612 9488 4524 Fax: 612 9488 4586

Name:
Email Address:
Do you want to be included in our email news?	Yes No
Retreat/Program:
Do you want to live in or live out?	Live in Live out
Street Addres
City/Suburb
State
Postcode
Country
Home Phone
Moblie
Work Phone
Fax Number
How did you hear about Canisius?
Do you have any special dietary or access needs?
Would you care to say briefly why you have chosen this retreat/program?

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