Authentic Journeys Life Coaching and Mentoring
Jennifer Kumar, LMSW
PO Box 284
Pittsford, NY 14534

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Rochester 101:
Introduction to the lifestyle and cultural landscape of Rochester

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Registration Form

Name:___________________________________________________________

Gender    Male   Female            Native Country:________________________

How long in Rochester?_____________________________________________

Address:_________________________________________________________

Phone:__________________________________________________________

E-mail:___________________________________________________________

Please return this form before Friday, September 25, 2009

With check or money order for $75 made out to Jennifer Kumar

Authentic Journeys
P.O. Box 284
Pittsford, NY 14534

If you have any questions, please call me, 585-387-9325

***If you want to pay by pay pal, read this.

I appreciate your interest and enthusiasm! Thank you!