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Registration Form: Summer 2023
Please use this form to register for Dignity Works Here - Summer Experiences
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Email
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Your email
Your Name - person completing the form.
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Your answer
Best contact phone number
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Your answer
Participant's name
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Your answer
Is the participant 18+? Currently, Dignity Works Here, Inc. programming is for participants 18 years and older
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Yes
No
Has the participant been enrolled in any other Dignity Works Here, Inc. programming.
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Yes
No
Would you like to register for
Project ELEVATE - All about Restaurants?
May 23 - June 29 (Tuesdays and Thursdays)
9:30 am - 2:30pm
RCC Hospitality and Culinary Center - Nyack NY
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Yes
No
Would you like to register for
All About Hospitality?
May 22 - June 28 (Monday and Wednesday)
3:30 pm - 6:00 pm
Bethany Retreat Center, Highland Mills, NY.
Please note: there is no class May 29 (Memorial Day)
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Yes
No
Would you like to register for
Summer Workshop Series?
July 10 - July 21 (Monday thru Friday for 2 weeks)
9:30 am - 3:00 pm
Bethany Retreat Center, Highland Mills, NY
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This class is currently full - please add me to the waitlist.
Do you have Self Direction?
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Yes
No
If you have Self Direction - who is your FI(fiscal intermediary)? Write none if you don't have self direction.
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Your answer
Send me a copy of my responses.
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