Small credit unions seeking tuition assistance for any educational event can

download and print an application for the Howe-Bergengren Education Fund here

View/download our color coded Distance Learning Calendar for January-June, 2010

I am registering those listed below for an event titled    

which is: (please select an Event type below)

being held: Month: Select January February March April May June July August September October November December     Day: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31     Time: Select 11:00 - 12:00 a.m. ET 1:00 - 2:30 p.m. ET 3:00 - 4:30 p.m. ET Other

Note ... all items displayed in bold red type below are required

Notes (special requests or other pertinent information):

Name of contact person completing this form: First Last

Credit Union: Select Bennington E/E Federal Border Lodge Bryant Federal Caswell Central VT Med Center, Inc. Champlain Valley Covered Bridge Credit Union of Vermont CVPS Employees' Granite Hills Green Mountain Heritage Family Federal Members 1st Members Advantage Community New England Federal NorthCountry Federal Northeast Schools and Hospital Opportunities Orlex US Government ECU P.M.H. River Valley Rutland Cty Teachers/Mun. ECU St. Patricks Parish United Community VT Federal VT State Employees VT VAF Employees Federal White River Windsor County South   Your Email:

Organization name (if not a VT credit union):

Your Phone: Ext.   Fax Number:

CONTACT INFORMATION

I am the contact person
Registrant #1 is the contact person

Other contact person - Name/email:

REGISTRANT INFORMATION

#   First Name          Last Name          Email                         Additional registration information

1. 

2. 

3. 

4. 

5. 

6. 

Would you like to receive a Training Certificate personalized for your credit union which can be completed with the participant names to signify that they have completed this training. No  Yes