Event Title: |
Region 11 EHDI Community of Practice |
Agency: |
Metro ECSU |
Location: |
Virtual Meeting
|
Facility: |
Virtual Meeting |
Date/Time: |
5/20/2024 |
01:00 PM - 03:00 PM |
|
|
* First Name: |
|
* Last Name: |
|
Preferred Badge First Name: |
|
* Organization Type:
|
(start typing the name to locate your organization in the list)
|
MN Public School
*
|
|
MN Public Charter School
|
|
MN Private School
|
|
Agency/Other
*
My Organization is not listed above. I want to enter my Organization.
|
|
Individual
|
|
* Email: |
* This will be your login ID
|
* Confirm Email: |
|
* Password: |
(must be at least 6 characters long)
|
* Confirm Password: |
|
* Position / Title: |
|
* Phone Number: |
Ext.
|
Fax Number: |
|
* Do you Require Special Accommodations? |
|
Home Address: |
|
Home City: |
|
Home State/Country: |
For United States and Canada: |
|
For Other Countries: |
|
|
Home Zip: |
|
Home Phone: |
|
Cell Phone: |
|
Home Email: |
|