Exploring Evaluation Webinar Series Registration

 

This webinar series is now full and we are taking a WAIT LIST.

If you are still interested in applying, please read the information below thoroughly. 

Webinar series runs January 25, February 1 and 8, 2018 from 9:30 – 11:00 AM PT.  Application indicates commitment to attend all 3 sessions.

Information collected via this application form is confidential and will be used solely for the purposes of determining attendance, evaluation purposes and for post-event follow up by the event sponsors. PAN is offering this series as a professional development opportunity to a limited group of participants.

Evaluation Webinar Series I

Name(Required)

Registrant Background Information for Evaluation Purposes

We are gathering information for evaluation purposes. Please fill in your information below.
Which health region do you live or work in?(Required)
How would you describe yourself? (check all that apply)

Media Release Ackowledgement

In participating in this webinar series, I acknowledge that PAN records webinars and that my name and voice may be recorded during this process. I give PAN the right and authority to use my name, voice, and image if applicable, for their purpose, both commercial and non-commercial.
I give permission for my voice and name to be recorded.(Required)

Confirmation of Commitment

PAN is offering this series as a professional development opportunity to a limited group of participants. I understand that in registering for this webinar series I am committing to all 3 webinars: January 25, February 1 and February 8, from 930-11 AM Pacific Time.
I am committing to attendance on January 25, February 1 and 8, 2018(Required)