From Hurt To Healing

Conference Registration Form

Most Excellent Way Life Center
Rev. Gloria Walton, Founder / CEO
From Hurt to Healing
"Restoring Lives...Miracles Do Happen"

OCTOBER 20, 2017
8:00 a.m. - 5:00 p.m.
New Jersey City University

(Last day for registration is October 15, 2017)

First Name *:
(will appear on conference badge

Last Name:

Organization / Company Name:


Apt / Floor:



Zip Code:

Contact Number *:

Email Address *:
(you will be sent a registration confirmation)

Do you require accommodations?

 Yes  No


 Entire Conference Day Package ($125.00)

 Workshop #1 Only Mass Incarceration:  "Our Most Threatening Social Justice Issue" ($65.00) Speaker Khalil A. Cumberbatch, MSW

 Workshop #2 Only "Grief and Loss: Forgotten Issues of Incarceration and Womanhood" ($65.00) Speaker Helena D. Lewis MSW, LSW, LCADC

 Community Awards Luncheon Only "Fatherhood Engagement Awards" ($65.00)


Total Registration Fee:


Method of Payment: Credit or Debit Cards, PayPal, Business or Certified Checks Only

Satisfaction Guarantee:
Your satisfaction is our goal and our guarantee. Concerns should be addressed to MEW, PO Box 716, Bayonne NJ 07002 or call (201) 333-8810 of Fax (201) 603-1179

ADA Needs:
We would be happy to accommodate your ADA needs; please call conference team at (201) 333-8810

Cancellation Policy:
Cancellations received at least ten days before the event are refundable less $30 administrative charge per registrant. A refund or voucher will be issued to any participant who is registered  to attend a workshop that has been cancelled by MEWLLC. If registration or payment is not received 10 days prior to the event, your certificate may not be ready at the conference.




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Most Excellent Way Learning Life Center. P.O. Box 716, Bayonne, NJ 07002
Office: (201) 299-7993, Cell: (201) 898-3610 .E-mail:


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