Event Registration

Citizen Preparedness Corps - User Registration

Event Title:

Harlem Road Community Center

Event Location:

Event Date:

January 11, 2025

Event Start Time:

03:00 PM

Event End Time:

05:00 PM

Event Description:

CPC Event at Harlem Road Community Center

The event is either not available for registration or has not been published.

Registrant Details

First Name*

Middle Name

Last Name*

E-mail*

Phone Number

Home Address Line 1 *

Home Address Line 2 (Apt, Suite, etc.)

City*

State*

Zip Code*

County*

Do you Require Reasonable Accommodation? (2 weeks' notice is required)*

Yes

* You will be contacted to confirm this request, please provide a valid email address and phone number when you register.
** If multiple Reasonable Accommodations are needed then select "Other" and list out each reasonable request.

How did you learn about this CPC Program?*

Citizen Preparedness Corps - User Registration

Registrant Details

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