Registration Form for "Discussing Difficult Issues Gracefully!"

Please complete the registration form below. The following questions will help us to understand the needs of our audience in advance.
Half Day Workshops are 9:00 AM to 1:00 PM.  
January 17, 2020, Friday, at Virginia Tech Richmond Center,
2810 Parham Road, Suite 300, Richmond Virginia 23294

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* 1. Personal Information

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* 2. Current Position:

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* 3. Previous Position

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* 4. Rank the importance of the following in your work:

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* 5. In which of the following areas are you seeking to gain new skills? Choose as many as may apply.

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* 6. We like to learn more about our participants as we plan our trainings. You may upload a resume if you wish.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 7. Photo/Video Release

Legacy uses media for its non-profit purposes. We do not share information with other organizations or companies. 

I hereby grant Legacy International (LI) non-revocable permission to capture my image and likeness in photographs, videotapes, motion pictures, recordings, or any other media. I acknowledge that LI will own such images and further grant LI permission to copyright, display, publish, distribute, use, modify, print and reprint such images in any manner whatsoever related to LI. I further waive any right to inspect or approve the use of the image by LI prior to its use. I forever release and hold LI harmless from any and all liability arising out of the use of the images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the images, including without limitation, claims for invasion of privacy rights or publicity.

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* 8. Payment options

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