National Judicial Institute on Domestic Violence




Enhancing Judicial Skills in Elder Abuse Cases Workshop

Application Form

YOUR REGISTRATION IS NOT CONFIRMED UNTIL YOU RECEIVE AN ACCEPTANCE LETTER

(Late applicants may be accepted if space is available)

APPLICATIONS MUST BE RECEIVED BY: 2012-07-10

First Name:
Last Name:
Title:    
Other Title:
Court:
Address:
Address 2:
City:      
Zip Code: 
Phone:    Fax:   
Email:

I have the following special needs:

I agree to attend ALL SESSIONS of the workshop  

The educational portion of this workshop is free of charge.  There is a $75 activity fee that will offset the costs of the workshop that our grant cannot cover.

YOUR REGISTRATION IS NOT CONFIRMED UNTIL YOU RECEIVE AN ACCEPTANCE LETTER