The Women's Center Waukesha Wisconsin
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Summer Evening on the Lake Registration
Please take a moment to fill out the form below.
 
* Required Fields

 
EVENT
Number of Tickets:
     Note: Tickets are $125 each.
 
YOUR INFORMATION
*First Name:  
*Last Name:    
*Address:    
  Address2:    
*City: *State:
*Zip:  
*Day Phone:    
*E-mail:  
       
GUESTS FOR WHOM YOU ARE PAYING:(Include yourself if attending)
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.
       
     
       


505 North East Avenue, Waukesha, WI 53186
262-547-4600, Crisis Line 262-542-3828, FAX 262-522-3882
mail@twcwaukesha.org
The Women's Center, Inc. is a 501(c)(3) charity
and a United Way agency
Web site funded by a grant from the SBC Excelerator Program