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This registration form is for groups or individuals registering for a multi-day Building Healthy Communities© training of the facilitator session who will submit payment online by credit card.

Registration Information

Please indicate your professional discipline.
  • Health/PE Teacher
  • Science Teacher
  • Counselor
  • Social Worker
  • Other

Contact Person Name*
Contact Person School
Contact Person Email*

Building Healthy Communities Training of the Facilitator Registration

Quantity
Price
Total
Training Fee

Cost per teacher per curriculum to register for training

X
$
350.00=
$
0

Payment Contact Information

Country*
Email*
Confirm Email*
Phone*

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

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