BuildaBridge On-Site Training Registration Form
Please complete the entire form.  Blank spaces may delay processing.  Your responses will be automatically emailed to BuildaBridge for processing.  For questions, please call (215) 842-0428 or email abohl@buildabridge.org.

Unless otherwise noted, all professional development courses take place at the BuildaBridge House, located at 205 W. Tulpehocken St, Philadelphia, PA 19144.

For the all day courses, a light breakfast will be provided, but please bring your own lunch.
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Personal Information
First Name *
Last Name *
Address *
City *
State *
Zip *
Email *
Phone Number *
Organization
Are you a BuildaBridge staff member?
Occupation
How did you hear about this training? *
Please list any additional people attending from your organization.
Include name and email addresses for each.
2014 Professional Development Courses
Please note all courses listed below begin at 9 am and conclude at 4 pm.  View full course descriptions at www.buildabridge.org/programs/professionaldevelopment/.
Please choose the training(s) for which you are registering for from the list below. *
Required
Cost & Discounts

The cost for each course listed above is $125.  An organizational group rate of 20% is available to organizations who send two or more individuals.  
Payment

The most convenient online payment is an electronic funds transfer from your bank.  What does this mean?  Go to your online banking account and set up BuildaBridge International as a Payee.  Use this address:  205 West Tulpehocken Street, Philadelphia, PA 19144.  Use this phone number: 215-842-0428.  Send the money from your account as a payment or online check.  This is safe and reduces any charges to you or BuildaBridge.

Checks can be made payable to BuildaBridge International.  Payment can be mailed to 205 W. Tulpehocken St, Philadelphia, PA 19144.   Cash is accepted.

NOTE:  Payment must be received no later than the day of training!  If payment is not received, you will not be allowed to participate.
How will you be making the payment? *
Required
Thank you!

Thank you for registering for a BuildaBridge professional development course.  Confirmation of your registration as well as training details and an invoice will be sent to you within one week.
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