Booking Request

Workshop Booking Request

Our free workshop, Careers in Healthcare for the New Millennium, is hosted by gyms, schools, churches, and clubs. If you would like to host our workshop for your organization, read the Conditions, then complete and submit the Booking Request below.

* Indicates required field

Name: *

First

Last

Email: *

Phone #: *

Have you read and agree with the Conditions for hosting our Workshop for your organization. * *

Yes No

Name of hosting Organization: *

Your Position or Title: *

Preferred Date: *

Start Time: *

End Time: *

Street Address: *

City: *

State: *

Zip: *

Comments & Questions (optional): *

Submit