Mansfield University Home PageCHILD ABUSE RECOGNITION AND REPORTING WORKSHOP
Wednesday October 14, 2009
6:00pm – 9:00pm
Memorial Hall, Room 211
Please arrive early for registration. Class will begin promptly at 6:00pm. Attendance at the entire class is required to ensure certification.
Name _____________________________________________________________
Home Address ______________________________________________________
___________________________________________________________________
Home Phone ______________________ e-mail ____________________________
Registration Deadline: October 9, 2009
Return this form and check in the amount of $30 (payable to Mansfield University) to 200 Memorial Hall, Mansfield, PA 16933. If unable to return this form by the deadline, please phone 570-662-4974/800-661-3460 or e-mail jbrion@mansfield.edu