Online Education Registration
This information will be used in the event that an education session has to be rescheduled or cancelled. Please complete this form once for each person who will attend the session.
Name
*
First Name
Last Name
Address (optional)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (optional)
E-mail
*
example@example.com
Select the session(s) that you are registering for :
*
Introduction to dementia and communication (February 19th 2021 @ 11:00 AM)
Are you familiar with Zoom video meetings?
Yes, I know how to join a meeting
No, I require information on how to use it
Unsure
Submit
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