LETRS Training, Modules 1-3

Registration Form

Module 1: June 30, 2009;  Module 2: July 1, 2009;  Module 3: July 2, 2009
Allegheny Intermediate Unit/McGuffey Room
8:30 a.m. - 4:00 p.m.

Content Questions?? Dyann Panepinto  - dyann.panepinto@aiu3.net
Registration Questions?? Shelley Hilton - 412-394-5709

Please complete the form below to register for the LETRS Training Summer 2009 Series.

Limited to 60 participants. Registration on a first come - first served basis.

First Name

  

Middle Name

  

Last Name

  

PPID #

  

E-mail

  

Home Address 1

  

Home Address 2

  

City

  

State

  

Zip

  

Employer

  

Position

  

Building

  

Work Phone

  

(Phone) Ext.

  

Fax

  
 

Payment for Materials
$80.00

 

 

   

 

 

 

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