Registration Information

Please complete the following registration information to sign up for the Cultural Humility Class.

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* 1. First name and last name

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* 2. E-mail address

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* 3. Phone number

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* 4. Affiliation(s) (check all that apply)

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* 5. Brief description of the communities or demographic groups you work with or plan to work with.

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* 6. How did you hear of the class?

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* 7. Are you interested in Continuing Education credits?

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* 8. Please tell us how you may be applying what you learn from this training

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* 9. Please tell us what languages other than English you speak (if applicable).

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