SAFEZONE Registration Form

Sign Me Up!


I would like to participate in a SAFEZONE training session:

Please fill out all sections of this form.
I would like to participate in the following SAFEZONE training session:
(Please choose one training session)
Session:

 March 28, 2011, 3:00 p.m. - 6:00 p.m., Butcher Suite (Kessel Student Center)
 March 29, 2011, 3:00 p.m. - 6:00 p.m., Butcher Suite (Kessel Student Center) 

I cannot make it on the above date(s). Please keep me informed of future dates.
Today's date:
Name:
E-mail address:
Phone number:
Campus (or other)
mailing address:
Classification: (please choose one)
If other
please describe:
Click SUBMIT.
Thank you for registering online to participate
in the SAFEZONE Education Program at Pace University.

For more information, please go to www.pace.edu/SAFEZONE  OR e-mail ccraig@pace.edu