2012 Promising Practices Exchange Registration Form
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1. 2012 HEAL Promising Practices Exchange: The Power of Partnership

 
Thank you for registering for the 2012 HEAL Promising Practices Exchange--The Power of Partnerships: Collaboration and Innovation for a Healthier Gold Country! This year's event will be held at the Robert J. Cabral Agricultural Center (2101 East Earhart Avenue, Stockton, CA 95206)from 9am to 2pm. The first 75 registrants will receive a complimentary healthy lunch provided through sponsorship by Health Net.
1. Please provide the following information:
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2. Lunch will be served between the hours of 11:30am and 12:30pm. We understand your schedule may not permit you to join us for the entire day - please indicate below if you will be joining us for lunch.
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3. Given that there is limited seating available and complimentary lunch offered, please provide 48 hours notice if you need to cancel your registration. We appreciate your courtesy!
4. Do you have any specific dietary needs? If so, please specify.
5. Would you like to host a workshop, or present a poster or display during the Exchange?
6. If yes, please provide the details below.