ASIST Registration Form: May 18-19, 2020
We look forward to seeing you at the upcoming ASIST workshop at Youth Villages from 8:30-4:30 on May 18-19, 2020. Breakfast and afternoon snacks will be provided at the training. Attendance for the full two days is mandatory. You will receive another confirmation email closer to the training date.
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Email *
Participant Name *
Participant Pronouns *
Participant Phone *
Participant Email *
Participant Address *
City *
State *
Zip *
Participant Employer *
Participant Employment Position *
Where did you hear about this workshop? *
Do you require any special accommodations?
To secure my place in the training, I will submit payment in the amount of $200: *
A copy of your responses will be emailed to the address you provided.
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