If you wish to register (or get more information) for the June/July training cycle complete the questions below. 

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* 1. Please provide your contact information:

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* 2. If the contact person for follow-up communication is NOT the same as the person completing the survey, please enter the contact person's information below.

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* 3. I am interested in registering a team for the times selected below (select all that apply)

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* 4. How many CNAs would you like to register?

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* 5. If you are interested in registering CNAs in both time slots how many do you want in each, please be specific. 

ex. AM 2, PM 5

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