REGISTRATION FORM FOR 40-HR. TRAINING

Name:                                                                                                                      

Organization you work for: ________________________________________

Address:                                                                                                                  

Email:                                                                                                                      

Phone (day)                                       (evening)                                            

(Please email to 40hrtraining@dvsolutions.org or fax to 805-963-1169 or mail to PO Box 1536, Santa Barbara, CA  93102)

STAFF AND VOLUNTEERS MAY ATTEND TRAINING FREE OF CHARGE

________  I wish to register for the 40-hr. training on domestic violence.

________  I would like to receive information about CEU’s.

________  Attached is my check for $140 or my scholarship request form.

How should I register? Email registration form or request form – 40hrtraining@dvsolutions.org

Or fax to 963-1169 or mail to P.O. Box 1536, SB, CA  93102

What is the cost?

$140.00 is the fee for the 40-hours, which includes manual.

For people registering for individual sessions, the fee is pro-rated.  Full and Partial Scholarships are available. Certificate of completion provided for those who finish the 40 hours.  CEU’s available (PCE#2421).  Questions?  Call 963-4458, ext. 11.