Thank you for registering for the SCAVC Fall 2015 Training: Engaging Skills Based Volunteers. Please complete the form below. You may submit your payment via PayPal at or by mailing it to:

Fairview Northland Medical Center
Attn: Jackelyn Bekius
911 Northland Drive
Princeton, MN 55371

Payment and registration form must both be received before your spot will be reserved. Questions? Contact Jackelyn at 763-389-6565 or

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* Please Provide Your Contact Information