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MANSFIELD UNIVERSITY – NON-CREDIT REGISTRATION FORM
SCHOOL VIOLENCE PREVENTION AND INTERVENTION WORKSHOP
Wednesday April 11, 2012
6:00pm – 8:00pm
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: Apirl 4, 2012
We regret that no refunds can be given after the registration deadline.
Return this form and check in the amount of $30 (payable to Mansfield University) to 209 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
Mansfield University is a community in the best sense of the word. We look out for each other. We push ourselves to dream big. We work hard to achieve success. We care. Mansfield welcomed its first student in 1857 – and to this day, the University continues to seek and serve students with big dreams for their futures.
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©2011 Mansfield University of Pennsylvania
Mansfield University of Pennsylvania
Mansfield PA 16933
Phone: (570) 662-4000
Admissions: 1-800-577-6826
Mansfield University is a member of the Pennsylvania State System of Higher Education
