REGISTRATION FORM

First Name *

Last Name *

Phone *

Date of birth

Address

District

Highest level of Education

Current Employment Status

Are you able to attend 10 sessions for 10 days from 9:00am-3:00pm *

YES

Preassessment will be held at the Orange Walk Central Office on Friday May 19, 2023 from 9 AM to 2 PM

Are you able to attend a Preassessment Session Friday May 19th? *