Character-Driven Workshops Dec 2020 Please enable JavaScript in your browser to complete this form.Select Class Location *St. Louis July 20, 2021St. Louis July 21, 2021St. Louis July 22, 2021Please print the pdf copy of the registration form and complete with all registrants attending. Upload or email to kcorvin@lhln.org. Your OrganizationName of Registrant 1 *FirstLastRank or Position Email Textable Phone Name of Registrant 2FirstLastRank or Position (Registrant 2)Email (Registrant 2)Textable Phone (Registrant 2)Name of Registrant 3FirstLastRank or Position (Registrant 3) Email (Registrant 3)Textable Phone (Registrant 3)Name of Registrant 4FirstLastRank or Position (Registrant 4)Email (Registrant 4)Textable Phone (Registrant 4)Please upload list of registrant(s) for 5 or more (include above information) Click or drag a file to this area to upload. You may send either a word file or use our pdf file under "check request form" To secure each spot, each registration requires a name, rank/position, testable phone and email address.Payment InformationBilling Contact *FirstLastBilling Contact Phone *Billing contact email *Select Number of Registrations Purchased *1 registration - $ 200.002 registrations - $ 400.003 registrations - $ 600.004 registrations - $ 800.00Registration is $195/registrant + $5.00 credit card processing fee. If you wish to avoid this fee, please download the pdf form, complete, and email Kelle Corvin at kcorvin@lhln.org and she will be happy to issue you an invoice to pay by check. We understand that schedules change and you may not be able to attend. If this happens, we will work with you to find another class location that suits your schedule. In the event that a refund is issued, a $100.00 fee will be withheld. Need to register 5 or more? Please email Kelle Corvin about volume discounts at kcorvin@lhln.org.Total$ 0.00Credit Card *Card NumberSecurity CodeName on CardExpirationMM123456789101112/YY2122232425262728293031Email to send receipt of payment *Phone of Cardholder *Billing Zipcode for CardSpecial InstructionsThis field is provided so to let the host agency and CCG know if a student attending will need any special assistance, such as "on crutches" or "needs wheelchair access" or need a seat close to the front for hearing/seeing issues or other related issues..NameSubmit