Lactation Education Workshop Registration Form. June 13th, 6pm-9pm est via zoom
Fill out the form carefully for registration
Your Name (As you want it to appear on the certificate)
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First Name
Middle Name
Last Name
Preferred Pronouns
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your E-mail
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example@example.com
Mobile Number
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Format: (000) 000-0000.
Why are you interested in this training?
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Do you have accessibility needs for virtual training, eg, captions, breaks, advanced materials.
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What's one topic you're most excited to learn about in this training?
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To finalize registration send payment of $150 via zelle to kaybeevillage@gmail.com. Workshop takes place June 13th, 6pm-9pm est via zoom
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Yes, I have read and I agree
Please verify that you are human
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