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* 1. Please provide your contact information:

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* 2. Academy Member ID Number

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* 3. Which online certificate of training program would you be interested in completing? (refer to program listing at https://www.eatrightstore.org/cpe-opportunities/certificates-of-training) (Scholarship value not exceed $200.00).

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* 4. If I am randomly selected, I understand that I will be reimbursed for the online certificate of training program (value not to exceed $200.00) , upon 1) satisfactory completion of the all related program modules and 2) posting an overview of my experience on the COGA Discussion Board.

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