CHOICES registration

 

Registration is contingent upon initial screening.

(* Denotes Required Fields)

Please provide the following information.
First Name: *
Last Name: *
Email: *
Organization or N/A: *
Address: *
Phone number: *
This number is : *	Office Cell Home
Type of Registration
I am a: *	Community Volunteer Professional
This training is provided at no cost to community volunteers. Cost for professionals is $125. Payment information will be included in your emailed confirmation.