Thank you for your interest in nominating a guest or yourself for a Confetti Celebrations Spa Retreat. Our goal is to provide a weekend spa retreat for women with cancer and the women who have supported them, that will refresh physically, restore emotionally, and rejuvenate spiritually. 

By completing this form, I affirm that the information provided is true to the best of my knowledge. I understand that this application allows the applicant/nominee to be considered for a Confetti Celebrations Spa Retreat—it does not guarantee their acceptance.   
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If no, have you/they received treatment in the last 12 months?
If yes, please describe profession. If no, feel free to describe a former occupation.
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