EVENT REGISTRATION FORM

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EVENT REGISTRATION FORM

If you would like to take part in our event, please fill in your details in the Event Registration Form below and you will be automatically registered. Event registration must be completed at least 15 days prior to the event.

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* Indicates required question

NAME *

Your answer

DESIGNATION *

Your answer

EVENT NAME *

Your answer

EVENT OUTLINE *

Your answer

STARTING DATE *

MM

/

DD

/

YYYY

ENDING DATE *

MM

/

DD

/

YYYY

TOTAL HOURS REQUIRED *

Your answer

ESTIMATE REVENUE *

Your answer

ANY RESOURCES NEEDED *

Your answer

YOUR EXPECTED PROGRAM OUTCOME *

LEAST EXPECTED

1

2

3

4

5

HIGHLY EXPECTED

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