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Understanding Opiate Addiction Workshop Registration Form
Time: 5:30 - 8:15 pm
Where: 80 Atwood Street, Brattleboro, VT 05301
Cusick Conference Room - 296
Contact: (802) 451-3560 or email dnuzzo@wsesu.org
Note: If class is under enrolled, the class will be canceled.
REGISTRATION DEADLINE - NOVEMBER 2, 2018

Name *
Your answer
Address *
Your answer
Email Address *
Your answer
Workshop Attending *
What days will you attend? *
Required
Need for Childcare *
Required
How many children?
Your answer
Meal *
Required
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