CE Registration Form for: The Who and What of Community Resources virtual presentation on Septemebr 7, 2022 at 12 noon
Fill out the form required items with astericks for CEU credit via email within 7 days of the attendance date.
Name
*
First Name
Last Name
Discpline
*
RN
Social Worker
Case Manager
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Preferred Phone Number
*
-
Area Code
Phone Number
Texas or other License # and state if not Texas
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