Clone of Impact of Social Structure

Impact of Social Structure - Registration July 28, 2020 10:30-11:30 a.m.

Please register by completing the form below. Registration is complete when this form is submitted and payment is made below with debit/credit card, or a check is received at the IBC office. You will be notified by email when your registration is complete. (Counts as 1.0 hour in Racial/Ethnic)
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Cellphone Number *

Area Code Phone Number
Payment Options *

Check Credit Card
If paying by check, submit this form and mail your check for the $20 training fee to: IBC, 225 NW School St., Ankeny, IA 50023

Call with questions: 515-965-5509

Registration Payment . A 3.5% fee will be added to all credit card payments

Registration Fee $ 20.00

Quantity

Subtotal $ 0.00 Tax $ 0.00 Total $ 0.00

Impact of Social Structure - Registration July 28, 2020 10:30-11:30 a.m.