| Your Name: |
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| Organization: |
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| Department: |
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Speedcode:
(or method of payment) |
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| Phone Number: |
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| Email: |
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Has Supervisor approved your registration?
(for Georgia State employees only):
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Do you require reasonalbe accommodation, due to a disability, in order for you to attend this workshop?:
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Describe accommodation requested or special diet needed:
|
| |
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