HCS/AAA Case Management & Program Training

 

Registration Fax Form for the week of february 12-16, 2001

supervisors only

 

To:              Carol Sloan, Home & Community Services, Fax:  360-725-2646

 

From:         Name__________________________________________ Phone_______________________

 

Fax____________________________Region/PSA:_________________________________

 

Date:           _______________________________                  # of Pages_________________________

 

Instructions for aaa and hcs social services staff:

Please list TWO nominated SUPERVISORS (N) and TWO alternates (A) to contact in case the first one cannot attend. 

 

Check

N	A	Name (spell)	Title	Office Address	Phone	Fax

 

 

 

Instructions for hcs financial staff:

Please list ONE nominated FINANCIAL SUPERVISOR (N).

 

Check

N	A	Name (spell)	Title	Office Address	Phone	Fax

 

Please fax this form to Carol Sloan, fax:  360-725-2646, NO LATER THAN FRIDAY, January 26, 2001.