Artificial Insemination Certification Program
Thursday, May , 9th 2019, 9am to 3pm and Friday, May 10th, 2019, 9am to 3pm
Fee: $125.00 per person - Class size is limited to the first 10 people that register and pay.
Town of Eau Plaine
111630 Equity St.
(For GPS use: EP410 Equity St)
City State Zip
Phone Number (Number where you can be reached during the day)
Would you prefer a Spanish version of the workbook?
Do you have special dietary needs?
Please read the following information and check the box indicating your agreement.
The educator(s) presenting may be taking photos for promotional purposes for future events. If I don't want my photo to be taken, I will contact the educator at the registration table.
Black or African American
American Indian or Alaska Native
Native Hawaiian and other Pacific Islander
Some other race
Two or more races
Hispanic or Latino
Not Hispanic or Latino
Under 18 Year
18 Years and Older
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