Project UNITE Overview, Online Web Course

Before You Begin | Syllabus | Course Navigation | Registration Form

Registration

Project Unite: The "A Step Curriculum"
Registration Form

Please PRINT and mail or FAX this Registration Form address at bottom

Date:
Phone:
Name:
Address:
City:
State:
Email:
Are you a (Please check): Staff Person at the LCDN El Rito Clinic	Yes No Other (Please describe)
Employer:
Occupation:
Course Fee:	Free
Taking class for Credit?	Yes No
Do you want a "Certificate of Completion" mailed to you once course is finished?	Yes No
How did you hear about this course?

Please PRINT and mail or FAX this Registration Form to:

Las Clinicas del Norte
c/o Project UNITE
PO Box 237
El Rito, NM 87530
Telephone 1-800-869-7624
FAX 505-581-4789

Virtual Conference Center

Course Overview | Case Studies | Modules

Resources | Discussion Rooms | Evaluation | Course Credit

Search | Home | Contact Us |

For website information contact roseh@unm.edu.