HUE Conversations - Partnership Registrations

Which course will you be attending as part of the HUE Conversation course? *

This training is hosted by East Central Iowa Council of Governments (ECICOG)

Location:
3^rd Floor Conference Room
700 16^th Street NE
Cedar Rapids, Iowa 52402

Doors open 8:30am

Course is 9:00am - 4:00pm

Please fill out the information below for the person attending the course (participant).

First Name *

Last Name *

Email Address *

Organization *

Title/Role *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone Number *

How did you find out about this course? *

I facilitate *

Coupon code (If applicable)

Do you need an invoice? *

Yes

No

Upon arriving at the forms payment page, please choose "pay by check" to submit the form without providing payment at this time and to be invoiced.

Lunch and snacks will be provided. Please list any allergies or dietary restrictions you may have.

If you need any special accommodations, please list them here. If accommodations are needed, please let us know one month in advance so we can plan accordingly.

For questions or concerns, please contact:

Irina Fursman
Phone: 763.232.2338
Email:info@hue.life