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.


    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.


    Interested in Faculty Training/Re-Training on Friday evening:

    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