Organization: Name: Address: City: State: Zip: Phone: Fax: Email: Activity Type: Classroom Training Demonstration Roundtable Discussion Other (describe) Activity Title: Activity and/or Demonstration Description: (please limit to two paragraphs) Name of Trainer: (Please include a short biographical description) Date Preference: March 26 March 27 Both days Time Duration: (One Hour blocks) Space Requirements: Inside Outside Both Language of Presentation: English Spanish Both Certificate offered? Yes No Please enter the letters you see below: Reload Image
Activity Type:
Classroom Training Demonstration Roundtable Discussion Other (describe)
Activity and/or Demonstration Description: (please limit to two paragraphs)
Name of Trainer: (Please include a short biographical description)
Date Preference:
March 26 March 27 Both days
Space Requirements:
Inside Outside Both
Language of Presentation:
English Spanish Both
Certificate offered?
Yes No