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
or by calling 503-284-6827 x 109.
First and Last Name (Nombre y Apellido)
First and Last
Phone number (Numero telefonico)
Email address (Correo electronico):
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Workshop You'd Like to Attend (Taller que le gustaria asistir)
Date and Location
Thursday - 10/25/2018 - 6:00-8:00 PM - Community Energy Project - 2900 SE Stark St. Suite A
Tuesday - 11/6/2018 - 6:00-8:00 PM - North Portland Tool Library - 2209 N Schofield St. Portland
City of residence (Ciudad de residencia)
Zip code (Codigo Postal)
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?)
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