REGISTRATION

Please complete the registration information below.

* Registrant Name

* Registrant Title

* Is your position federally funded?

* Organization Name

* Address

* County

* Phone xxx-xxx-xxxx

* Email

* Scholarship: Please check those you are applying for.

PLEASE NOTE:
THIS TRAINING IS FULL.

We will add your name to our Wait List. You will only be allowed to attend if you receive a confirmation email from OJA.

For questions, please call Lisa Tiedemann, 608-261-7005. Thank you for your interest in this training.

Once you have completed all the requested information, please click Done to submit your registration.

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