Casting for Recovery

Application form I would like to submit my name for a chance to attend the following CFR retreat for women at any age or stage of treatment and/or recovery from breast cancer:

Retreat event « Select »   Title « Select »MissMsMrsOther (please specify) First name Last name   Address Line 1 Line 2 Town County Postcode Country « Select »EnglandNorthern IrelandRepublic of IrelandScotlandWalesOther (please specify)    Daytime telephone Country code Mobile phone Country code Email Re-enter email   How did you hear about us? « Select »NewspaperRadioTelevisionInternet SearchBreast Cancer Support GroupMedical Care GiverFriendOther (please specify) If possible, please provide specifics, ie. Name of publication, website, support group, etc.   If we cannot offer you a place on your chosen retreat would you like to receive details of: Retreats in other countries this year? Yes     No Retreats in your chosen country next year? Yes     No   Would you like to receive occasional email newsletters and other information about Casting for Recovery? Yes No Enter       PASP4J A receipt will be emailed to your address. If you do not receive your receipt within a few minutes of submitting this email, please check that your receipt has not been directed to your spam box!

Registered office: Down Farm, Hindon, Salisbury, Wiltshire SP3 5TA. Casting for Recovery UK & Ireland is a company limited by guarantee registered in England and Wales.
Company number 06818943. Charity Registration Number 1135140