Course Day – December 7, 2019 Date: Saturday, December 7, 2019 Fee: $20.00 per person payable via credit card or Paypal account using this form. Fee is non-refundable unless event or course is cancelled. Location: Ramada Inn and Conference Center 100 Ramada Inn Drive Greensburg, PA 15601 Course Selection (required): THIS IS A GRADUATE COURSE ONLY. You must have taken Parts I, II, and III to be eligible to take this course. Graduate Interested in Faculty Training/Re-Training on Friday evening: YesNo Your Full Name (required): Your Badge Name (required): The name you want others to call you (i.e., your first name). Your Address (required): Your City (required): Your State (required): Your Zip (required): Best Telephone Number to Reach You (required): Your Email (required): Your Rotary Club (required): Your District Number (required): Years in Rotary (required): Special Dietary Needs (required): We will contact you if "Yes". NoYes Terms and Conditions (required): Registration fee ($20.00) is non-refundable unless event or course cancelled. I Agree To and Accept Terms and Conditions [recaptcha]