Registration Form

In person Orientation is open to Great Start Parent Liaisons and Collaborative Directors. There is no charge to attend and lunch will be served.

Location:
Early Childhood Investment Corporation
105 W. Allegan, Suite 200, Lansing, MI  48933

A map and further details will be provided to you in a confirmation email about one week prior to the training date.
Registration will begin at 8:30 a.m.  The training will start promptly at 9:00 a.m. and concludes at 3:30 p.m.

First Name:

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* 1. First Name:

Last Name:

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* 2. Last Name:

Title:

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* 3. Title:

The Great Start Collaborative or Great Start Parent Coalition you are representing (county):

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* 4. The Great Start Collaborative or Great Start Parent Coalition you are representing (county):

Email address:
(Enter the email you prefer that ECIC use to contact you.)

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* 5. Email address:
(Enter the email you prefer that ECIC use to contact you.)

Yes, I will attend the following in-person orientation training:

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* 6. Yes, I will attend the following in-person orientation training:

What topics do you want to learn more about at this in-person orientation?

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* 7. What topics do you want to learn more about at this in-person orientation?

Please let us know of any dietary restrictions or food allergies.  We will inform our caterer of your request however each caterer has their own guidelines and protocols.  

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* 8. Please let us know of any dietary restrictions or food allergies.  We will inform our caterer of your request however each caterer has their own guidelines and protocols.  

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