MGIA ONLINE TRAINING REGISTRATION FORM
  
* All Fields must be filled out or Registration will be void.
* A registration for EACH ATTENDEE must be completed and submitted.
* A seperate form mut be completed for each MGIA training event event you are attending.
  
Attendees Information
.
  
Name: (Last, First, MI):
*
Contact Phone Number:
*
Email Address:
*
  
Attendee Employing Agency Information
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Agency Name:
*
Agency State:
*
Agency Phone Number:
*
Title/Rank:
*
Supervisors Name::
*
  
Additional Applicant Information
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Registering for the following event:
  
Additional Comments:
  
  
I am paying for conference via:
PayPal: | Mailing Check: | Voucher: | Other: (If other please list details in comments box)
  
  
  
After submitting this form you will be taken to a confirmation and PayPal payment page.
    
  
  
  

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