Name *

First Name

Last Name

Phone *

(###)

###

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*About* how many participants are you expecting? *

9 or less ($360)

10-20 ($700)

21+ ($33 per person)

I would like to host this training *

Virtually via ZOOM (MD, PA, DE, WV, DC)

In person at my childcare location (Note: We have a 60 mile travel radius)