Free ECE Workshop
Featuring Lisa Murphy, The Ooey Gooey Lady®!
Saturday, April 13, 2024
8:00 a.m. - 3:00 p.m.
Kaskaskia College
Name:
*
First Name
Last Name
Email:
*
example@example.com
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth:
*
mm-dd-yyyy
Current Place of Employment?
Will you be attending for CPDUs or CEUs? If yes, please indicate which one:
CPDUs
CEUs
Not seeking credit hours
Gender
*
Male
Female
Non-binary
Prefer not to disclose
High School Attended?
*
High School Graduation Year?
*
College Attended?
College Graduation Year?
Highest Diploma/Degree Earned?
None
High School
GED
Some College
Certificate
Associate Degree
Bachelor's Degree
Master's Degree
Professional
Doctoral
Other
Are you Hispanic or Latino Ethnicity?
*
Yes
No
Race: (Please select all that apply.)
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Choose Not to Respond
Submit
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