Workshop Title *
First Name *
Your answer
Last Name *
Must match your RID record exactly to receive credit.
Your answer
E-mail Address *
Your answer
Credit Desired *
Rid # *
required for CEU credit (type n/a if you do not have an RID number and DO NOT need RID credit submitted)
Your answer
Only if new
Your answer
Phone Number *
Your answer
UTRID Membership Status *
Please list your accommodation request(s) below. If registering 2 weeks prior to the event, all reasonable attempts will be made to provide the requested accommodations.
Your answer
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