Event Registration

Designing our future CANHS Workshop 2018

Members and advisers will craft the next generation of service, training and support that will be CANHS 2018 and beyond!
  • Date: May 31, 2018
  • Time: 9 a.m. - 1 p.m.
  • Site: CAS 30 Realty Dr. Cheshire CT 06410
  • Registration Deadline: May 25th 2018
  • Cost: No Charge
  • Directions/Information:
    Space limited.

    Light breakfast and lunch provided

    If you have any questions please contact Jadzia Herrmann Brown: jbrown@casciac.org Phone: 203-250-1111 ext 3940

    Its important to inform us about any cancellation, space is limited. We want everyone be able to attend.


Note: Items with * are required.
Registrant Name*: First*:
Last*:
Affiliation*:
Phone*:
Fax:
E-Mail*:
Re-Enter E-Mail*:
Mailing Address*:
City, State and Zip*:
Advisors: First/ Last / Email
Student 1: First / Last/ Grade
Student 2: First / Last/ Grade
Student 3: First / Last/ Grade
Student 4: First / Last/ Grade
Student 5: First / Last/ Grade
Student 6: First / Last/ Grade
Student 7: First / Last/ Grade
Student 8: First / Last/ Grade
Student 9: First / Last/ Grade
Student 10: First / Last/ Grade
Total number attending
Comments