Registration

* Indicates required field

Participants Name *

First

Last

Email *

Title *

Grade Level *

School *

Select Dates *

District *

PO# or Payment Contact Name *

Distance Learning Platform Used By District *

Have you previously been GLAD trained? *

Yes No

IMPORTANT INFORMATION

A written Purchase Order or payment by check must accompany registration to confirm attendance.
Refunds will only be given with a 5-day notice.
Online resource guide and login information will be provided prior to training
Please make checks or PO’s payable to:
- Kelli Richardson at kelli9294@gmail.com
- 1411 Morse Court, Napa, CA 94558
- (707) 227-7442

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