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ERSI 101 Course Registration

Specialist Information

Specialist Name*

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Last

Specialist Email

Scholars Award #

Fill out a separate form for each Scholars Award #

Program Information

Program Name

Director's Name*

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Last

Director's Email

Number of Participants*

ERSI Course Name*

Participant Information

Participant #1

Name*

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Last

Aspire #*

Email address*

Participant #2

Name

First

Last

Aspire #*

Email address*

Participant #3

Name

First

Last

Aspire #*

Email address*

Participant #4

Name

First

Last

Aspire #*

Email address*

Participant #5

Name

First

Last

Aspire #*

Email address*

Participant #6

Name

First

Last

Aspire #*

Email address*

Participant #7

Name

First

Last

Aspire #*

Email address*

Participant #8

Name

First

Last

Aspire #*

Email address*

Participant #9

Name

First

Last

Aspire #*

Email address*

Participant #10

Name

First

Last

Aspire #*

Email address*

Hit the Send button to submit your registration. Once your award is processed, participant(s) will receive an email with login information to the training portal.

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