Colorado Rural Health Center | CRHCGP Workshop Registration Form

Pre-Application Grant Writing Workshops Registration Form

Important Information Cost: Free Lunch will be provided Must pre-register to attend; no walk-ins allowed Workshop Registration Deadline: 3 business days before workshop date Registrant Information Warning: Hitting the "enter" key will submit the form. Use TAB to navigate through fields.
Name:
Title:
Organization:
Address:
City:		State: Zip Code:
Email:
Phone Number:
Dietary or other special needs:

Workshop Options

Tuesday, January 31, 2012
10:00am - 3:00pm

Colorado Rural Health Center
3033 S. Parker Rd., Ste. 606
Aurora, CO 80014

Past Workshops

Thursday, January 12, 2012
Montrose Memorial Hospital
800 S. Third St.
Montrose, CO 81401

Wednesday, January 18, 2012
Arkansas Valley Regional Medical Center
1100 Carson Ave.
La Junta, CO 81050

Workshop Map

Select the workshop(s) you will attend (hold down ctrl to select more than one option):
How much grant writing experience do you have?
Have you written healthcare-related grants before?		Yes No
If no, what other kinds of grant proposals have you written?
		- PLEASE CLICK ONLY ONCE