Training Registration Form | Springfield Urban League

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Training Program Events

Web-Based Program

First

Last

Title

Title

How long have you worked at WIC?

years/months

Education

Race

Gender

Ethnicity

License number

Agency Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone

Attendee Cell Phone

Fax

Supervisor

Supervisor's Email

Trainee Email

Training URL

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