Jan. 20-21 Omaha Team Registration Form

Faith Partners Team Training
Omaha, Nebraska

to address substance use disorders, addiction, and related mental health issues

Click for Training Description

Faith Partners Team Training - Omaha January 2023

Registration form for Team Training January 20-21, 2023

Main Contact Name for Your Group *

First

Last

Congregation/Organization *

Main Contact Role *

Rostered Minister
Church Staff
Lay Person

Main Contact Email *

Main Contact Phone *

Main Contact Street Address *

Address Line 2

City *

State *

Zip Code *

Our Team is: *

New to Faith Partners Training
Has Completed an Earlier Training Session

Training Participant #1 *

First

Last

If your main contact is participating in training, please re-enter information as participant #1

Participant #1 Email *

Participant #1 Phone

Participant #1 Dietary Restrictions (if applicable)

Ex. vegan, vegetarian, gluten free, allergies

Training Participant #2

First

Last

Participant #2 Email

Participant #2 Phone

Participant #2 Dietary Restrictions (if applicable)

Ex. vegan, vegetarian, gluten free, allergies

Training Participant #3

First

Last

Participant #3 Email

Participant #3 Phone

Participant #3 Dietary Restrictions (if applicable)

Ex. vegan, vegetarian, gluten free, allergies

Training Participant #4

First

Last

Participant #4 Email

Participant #4 Phone

Participant #4 Dietary Restrictions (if applicable)

Ex. vegan, vegetarian, gluten free, allergies

Training Participant #5

First

Last

Participant #5 Email

Participant #5 Phone

Participant #5 Dietary Restrictions (if applicable)

Ex. vegan, vegetarian, gluten free, allergies

Training Participant #6

First

Last

Participant #6 Email

Participant #6 Phone

Participant #6 Dietary Restrictions (if applicable)

Ex. vegan, vegetarian, gluten free, allergies

Training Participant #7

First

Last

Participant #7 Email

Participant #7 Phone

Participant #7 Dietary Restrictions (if applicable)

Ex. vegan, vegetarian, gluten free, allergies

Training Participant #8

First

Last

Participant #8 Email

Participant #8 Phone

Participant #8 Dietary Restrictions (if applicable)

Ex. vegan, vegetarian, gluten free, allergies

Training Participant #9

First

Last

Participant #9 Email

Participant #9 Phone

Participant #9 Dietary Restrictions (if applicable)

Ex. vegan, vegetarian, gluten free, allergies

Training Participant #10

First

Last

Participant #10 Email

Participant #10 Phone

Participant #10 Dietary Restrictions (if applicable)

Ex. vegan, vegetarian, gluten free, allergies

Comments or Questions

Thank you to our Omaha Partners

Faith Partners Team Training Omaha, Nebraska

to address substance use disorders, addiction, and related mental health issues

Thank you to our Omaha Partners

Faith Partners Team Training
Omaha, Nebraska