Employee Training and Development

Registration Form

Please type or print legibly and fill out completely.

Name _______________________________________ GWid # _____________________

Phone # _______________ Fax # ________________ E-mail ______________________

Dept ____________________________ Position ________________________________

Address _________________________________________________________________

For campus address, write building and room number. If off-campus, include street, suite number, city, state, and zip code.

Supervisor/Dept. Head _________________________ Phone # _______________

To register, use Course Abbreviation/Section listed in the schedule.

Course/Section _________/____ Date _____________

Course/Section _________/____ Date _____________

Course/Section _________/____ Date _____________

Course/Section _________/____ Date _____________

Course/Section _________/____ Date _____________

Course/Section _________/____ Date _____________

Participant's Signature _________________________

Signature of Supervisor or Dept. Head (if applicable) _____________

Note to supervisors: Employees must attend class on scheduled work time.

Or fax to: (202) 994-0076

Confirmation of your registration will be faxed or e-mailed to you. If you do not have a fax machine, a member of our staff will call you. Please complete your e-mail address and your phone and fax numbers, with area code, in the space provided above.