ICDVVA Regional Roundtable & Training Registration Form
Hosted by the Idaho Council on Domestic Violence and Victim Assistance
Name
*
First Name
Last Name
E-mail
*
example@example.com
Job Title
*
Organization
*
Is your organization currently funded by ICDVVA?
*
Yes
No
Please indicate which Roundtable Training you will be attending:
*
Region 4: November 17th, 2022 @ Boise Chamber of Commerce
Please indicate which Roundtable you will be attending:
*
Region 4: November 17th, 2022 @ Boise Chamber of Commerce
For funded programs, the morning session is required but the afternoon training is not. Please indicate if you plan on attending all day, or just the morning:
*
Morning session only
All day
Please let us know of any accessibility accommodations:
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