SARE Animal Health Care Practices Workshop December 14, 2016

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Please complete this form to register for our workshop at UConn Extension in Vernon, CT on December 14, 2016. We provide equal program opportunity. Persons with disabilities requiring special accommodations should contact us 7 days prior to the date of the event.

Name *

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Email address *

Telephone

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Affiliation - please check all that apply

Farmer/Producer

University Extension/Educator

Non Profit Agricultural Service Provider

USDA Agricultural Service Provider

Other

Animal Health Care Professional

Race/Ethnicity -- please check all that apply

Male

Female

Black

White

Asian

Native American

Hispanic

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