Alaska Attachment
&
Bonding Associates

P. O. Box 872188
Wasilla, AK 99687-2188
907-376-0366 (Office)
907-376-0635 (Fax)
eleanor@akattachment.org

Training Registration Form

To register for a class, please fill out this form.
This form requires that you have a normal e-mail account/program such as outlook on your computer
If you do not have one please use one of the other methods for registration.
It will not work with web-based e-mail account such as Hotmail.
Name:
Organization (if applicable):
Mailing Address:
City, State, Zip Code:
Email Address:
Phone:
Training Title:
Date(s):
Dietary and other special needs:
Costs:
(Please mail check to PO Box 872188, Wasilla, Alaska 99687.
Or you can pay at the door before the workshop begins. )
Scholarship Needs:
Please click the SUBMIT button only once
Please call: 907-376-0366 if you have any further questions. If you will not be able to attend the workshop on the scheduled day, call: 907-355-0669. Thank you!

The submit button must be clicked for your form to be submitted.

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