Disaster Class Registration Form

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Disaster Preparedness Course Title:  Introduction to DisasterDisaster Action Team (DAT) OrientationDisaster Assessment WorkshopDisaster Health Services: An OverviewERV: Ready, Set, Roll, & Coaching the Van Driver IIFamily Service: Providing Emergency AssistanceHuman Resources in DisasterLogistics: An OverviewLogistics: A SimulationMass Care: An OverviewMass Care: Shelter OperationsMass Care: Shelter SimulationMental Health Services: An OverviewRecords & Reports

Please enter your first and second choice of date and time for the course above:

First Choice Date & Time:

Month:  JanuaryFeburaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember  Day:  12345678910111213141516171819202122232425262728293031  Time:  8:00 a.m.8:30 a.m.9:00 a.m.9:30 a.m.10:00 a.m.10:30 a.m.11:00 a.m.11:30 a.m.12:00 p.m.12:30 p.m.1:00 p.m.1:30 p.m.2:00 p.m.2:30 p.m.3:00 p.m.3:30 p.m.4:00 p.m.4:30 p.m.5:00 p.m.5:30 p.m.6:00 p.m.7:00 p.m.8:00 p.m.

Second Choice Date & Time:

Month:  JanuaryFeburaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember  Day:  12345678910111213141516171819202122232425262728293031  Time:  8:00 a.m.8:30 a.m.9:00 a.m.9:30 a.m.10:00 a.m.10:30 a.m.11:00 a.m.11:30 a.m.12:00 p.m.12:30 p.m.1:00 p.m.1:30 p.m.2:00 p.m.2:30 p.m.3:00 p.m.3:30 p.m.4:00 p.m.4:30 p.m.5:00 p.m.5:30 p.m.6:00 p.m.7:00 p.m.8:00 p.m.

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