Reverend Patricia Saunders, CEO/President - Domestic Violence   HIV/AIDS   Homicide   Pastoral Care
First Attendee
REGISTRATION FORM - DC Alliance Clinical Education Training Sessions
All Community Leadership Titles Select One
Name - (Last, First, M.I.)
Name of your Church
Address 1 - (Street, Suite/Apt.#)
Address 2 - (City, State, Zip)
Cell Phone Number
E-mail Address
Executive Assistant Name
Telephone Number
Payment Option
Cash/Check or Money Order - MAILED OR ON-SITE ONLY
Registration Fee
Register On-line you MUST Pay on-line or by Mail
At the Door CASH ONLY $20.00
CIT/Chaplains $15.00 (Discounted Rate is offered)
No Refunds after March 25, 2019
Donation any Amount $_________
Check or Money Order was Mailed:
P.O. Box 8753 Hyattsville, MD 20787