Addressing the Challenges of Poverty Registration The information requested in the form below will be submitted to staff members of aha! Process, Inc.. You will receive confirmation that we have received your submission via e-mail. If you have not received confirmation within two business days of submitting the application, please contact Alecia Chapman at achapman at ahaprocess.com or 800-424-9484. Pre-Registration Form Please take a moment to provide the information that follows (required fields are indicated by ).   Workshop, Date, Location Please make a selection Addressing the Challenges of Poverty - Sep 30-Oct 01, 2013 / Oklahoma City, OK / $395.00 Personal Information Title Mr. Ms. Mrs. Dr. First Name Middle Name Last Name Attendee's Email Address Mailing Address City State/Province Country Zip/Postal Code Home Phone School or Organization Information Organization or School District School Name (if applicable) School/Org. Mailing Address School/Org. City School/Org. State/Province School/Org. Postal Code School/Org. Phone School/Org. Fax Position with School/Org. Additional Information Are you attending this workshop for recertification for Bridges Out of Poverty? Yes    No Payment Information Payment Method Please make a selection Credit Card Purchase Order Purchase Order # (if applicable) Fax purchase order to (281) 426-8705 Trainer ID Questions or request for more information Please make sure @ahaprocess.com is on your "approved sender" list or "whitelist" and/or in your "address book." You should receive a confirmation email at the address you provided above. If you do not see an email from us in your Inbox folder, please check your Spam, Bulk or Junk mail folder as your ISP, software spam-blocker or filters may be diverting our e-mail.