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* 1. For which training are you registering?

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* 2. What is your name?

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* 3. What groups are you affiliated with? (Check all that apply)

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* 4. What is your email address?

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* 5. What is the best phone number to reach you at regarding updates on this training?

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* 6. Lunch will be provided by NHDART.  Please note any dietary preferences.

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