Lactation Link Event Registration

Please fill out this form to register for Lactation Link. You may select as many dates as you would like to attend. We look forward to seeing you soon!

Name*

First NameLast Name

Profession or Licensure*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

E-mail*

Place of Employment*

Event Date Choice (select as many as you would like to attend)

Are you interested in CEUs at our Lactation Link?

YesNoOther

Lactation Link Registration