Lead Safe Home Projects Workshop Registration
Please fill out this form to secure your spot in one of our upcoming workshops! If you don't see a day or time that works for you, feel free to contact our Lead Poisoning Prevention Coordinator and let them know. We would be more than happy to find a way to provide you with our information and workshop. They can be reached at Lead@communityenergyproject.org or by calling 503-284-6827 x 109.
First and Last Name (Nombre y Apellido) *
First and Last
Your answer
Phone number (Numero telefonico) *
Example: 555-897-6587
Your answer
Email address (Correo electronico): *
Your answer
Would you like to be added to our monthly e-newsletter list? *
You can unsubscribe at any time.
Workshop You'd Like to Attend (Taller que le gustaria asistir) *
Date and Location
City of residence (Ciudad de residencia) *
Your answer
Zip code (Codigo Postal) *
Your answer
Do you rent or own your residence? (¿Usted alquila o es dueño de su casa?)
How did you hear about our workshop? (Como se encuentra sobre el taller?) *
Your answer
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