Mansfield University of Pennsylvania

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Mansfield University Home Page > Teacher Education & Educational Field Experiences Home Page > Child Abuse Workshop

MANSFIELD UNIVERSITY – NON-CREDIT REGISTRATION FORM
CHILD ABUSE RECOGNITION AND REPORTING WORKSHOP

Name _____________________________________________________________

Home Address ______________________________________________________

___________________________________________________________________

Home Phone ______________________ e-mail ____________________________

Registration Deadline:  April 12, 2013

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

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