1. Please tell us about yourself.

If you have previously registered, please login here to prepopulate your information.

 

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If you respond and have not already registered, you will receive periodic updates and communications from Fenway Health.

 

 

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  Phone number(s) we can use to contact you:
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Question - Not Required - Which phone number would you prefer us to use?



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Question - Not Required - Will you be attending The Women's Dinner Party Table Selection Party Thursday, April 2, 2015 (location to be announced)? All registered Table Captains are invited to attend. Tables will be chosen in the order in which they were paid.

 

 

By agreeing to be a Table Captain I understand that I should contact Fenway Health by Friday, March 27, 2015 if I have open seats at my table so that Fenway can assist in filling the open seats.
 
 

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