3000 Dundee Road, Suite 411-412, Northbrook IL, 60062 (847) 205-0371

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Registration - Classes and Workshops Fill out the following form to register. You will receive an email confirmation once you have been registered. Add a comment if you wish a confirmation phone call. First Name: Name*: Address: City/State: Phone: Email: Select Class: (please select) Please notify me ONCE when the NEXT Marriage Classes are offered Please notify me EACH TIME Marriage Classes are offered Number of Attendees: Names of Additional Attendees: Comments:

North Shore Wellness Services, Ltd.   3000 Dundee Road, Suite 411-412, Northbrook IL 60062 phone: (847) 205-0371  fax: (847) 205-0377 © copyright North Shore Wellness Services, Ltd. an Illinois company, 2011.