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Registration for Bed Bug Workshop for Homeless Shelters - Houston
Use this form to register for the Houston Area, December 10th program on bed bugs. There is no charge to attend, but we request all participants to register in advance.
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Name
*
Please let us know your name as you wish to have it appear on your name tag
Your answer
Affiliation
*
What type of organization will you be representing?
Non-profit shelter
Church
Government agency
Other:
Shelter or Organization name?
*
Your answer
Email
*
For purposes of communicating about bed bugs and this program only
Your answer
Mailing Address
Best address for mailing information about additional training opportunities
Your answer
Phone
Your answer
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