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* 1. Does your program have at least one person with a valid Food Safety Certificate on file?

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* 2. Choose a Food Safety Training Date: (Training is held at the Mid-Ohio Foodbank)

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* 3. Attendee Name (Limit 2 per session):

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* 4. Agency Name:

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* 5. Agency ID Number:

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* 6. Type of Program (click the drop down box)

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* 7. County:

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* 8. Contact Phone Number:

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* 9. Contact Email:

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