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NEW Partnership Trainer Confernce Registration Form

To ensure the accuracy of your registration, please complete all the fields on the following form.  When completed click on the "Register" button at the bottom. Please register one person registration form. 

Name*:
My name has changed:  It was:
Partnership*:
Home Address*:
City*:

Zip Code:*
E-Mail:*
Work Phone:*
Home Phone (Optional):
Fax:*
Confirmation letters will be faxed within one week of our receiving this form

Vegetarian Meal

If you require disability-related accommodations please contact Liz Hessler @ 920-465-2724. Requests for accommodation should be made as soon as reasonably possible and no later than 14 days prior to the event
Please register me for the following
Day 1 A.M. Session - Choose One: Day 1 P.M. Session - Choose One:






Day 2 - Overview of Worker CORE
PowerPoint Questions: List your specific question(s) about PowerPoint below or email them by December 1 to Pat Scieszinski, scieszip@uwgb.edu
Questions for the Master Trainer:: List your specific question(s) below or email them by December 1 to Pat Scieszinski, scieszip@uwgb.edu

Confirmation Letter: You will receive a confirmation letter by fax or be contacted about being put on a waiting list within five working days after we receive your registration.  This letter is your receipt.  If you do not receive confirmation prior to attending training you should call 920-465-2724 to check the status of your registration.  Please do not attend training without confirmation.

Please Note: Your name as it appears on this registration is how it will appear on all training related documentation (i.e. confirmation letters and nametags).
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URL: http://www.uwgb.edu/newpart/
University of Wisconsin - Green Bay
NEW Partnership for Children and Families
Cofrin Library 750
2420 Nicolet Dr.
Green Bay Wisconsin 54311
920-465-2724

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Last Updated: October 25, 2006