RAC-R Training Form
The purpose of this form is to broadcast training held by each organization in the region to provide training for all providers. Please fill out the form to notify when your training is and how you can be contacted.

** Note: reference page 3 of this form for a list of classes that are funded by the RAC: https://rac-r.com/wp-content/uploads/2018/10/RAC-R-Request-for-Professional-Development-2019-2.pdf

Start Date *
MM
/
DD
/
YYYY
Start Time *
Time
:
End Date *
MM
/
DD
/
YYYY
End Time *
Time
:
Class being held: *
Your answer
Location of class: *
Facility Address
Your answer
Registration link:
(If Applicable)
Your answer
Point of Contact Name: *
Your answer
Point of Contact Agency: *
Your answer
Point of Contact Email Address: *
Your answer
Notes / Comments
Your answer
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