CottingConnection
                                Survivor's Resource Guide
                    –   Pre-Registration Form   –
If you are interested in being a sponsor of this year's conference, we'd love to hear from you!
conference info
Call us at: 617 795-2214
Email us at: info@cottingco.com
conference info
Cancer Rehab Conference Info
Cancer Rehab Conference Registration
Cancer Rehab Conference Schedule
Cancer Rehab Conference, Contact Us
Breast Cancer Survivor's Reource Guide
Resources for Beast Cancer Survivors
Cotting Companies
38 Waban Street
Newton, MA  02458
617 795-2214
info@cottingco.com
Name      Company (if applicable)
Home Address    Work Address  
City State Zip
City State Zip
Home Phone   Business Phone  
Email   Work Email   
Occupation
Are you a cancer survivor?     yes   no

When:  Friday & Saturday   October 5th & 6th  8:00 am – 4:30 pm
Where:   Simmons College   William J. Holmes Sports Center   331 Brookline Avenue  Boston, MA
http://www.simmons.edu/visit/directions.shtml (building #12)
click here for mapquest map
Tuition:   
$295  Professionals
                           $75 Students & General Public
Includes entry into Breakout Sessions for Professionals
(see schedule for Conference for description)

$75 Survivors 
Includes entry into Workshops and Demonstrations for Survivors
(see schedule for Conference for description)

Group rate and Angel Scholarships are available. Please call our office for details.


I plan to attend the Cancer Rehab Conference 

Print this form if you'd prefer to mail it to us.
Send, along with your check to:  Cotting Companies   38 Waban Street  Newton, MA  02458

If you registered before September 10th, please contact our office at (617) 795-2214.
Due to a technical problem, we may not have your registration.