JATA Classroom Registration

Fill out the form below to register for class. This information needs to be completed as it should appear on the CEU Certificate

Participant Name: *

Title/Credentials: *

License #: *

Email: *

Phone:

Name of Facility: *

Department:

Address: *

In-Person Classroom   WebEx

Dates of Attendance: *

Upcoming Classroom Dates

Eastern Time Zones
Mon-Thur: 8:30-4:30, Fri: 8:30-12:30
July 28 - Aug 2
October 6 - 10**
December 1 - 5**

Western Time Zones
Mon-Thur: 7:00-3:30, Fri: 7:00-11:00
August 25 - 29
November 10 - 14**

*Required fields.

**Dates subject to change. Cut-off date for registration is 3 weeks prior to the scheduled date of Class.