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FASD Training Request

Please complete and submit the following information to request training from the Great Lakes FASD Regional Training Center.

* Required Field

Contact Information:
Contact Name
Agency
Mailing Address
City
State
Zip
Phone
*Email
Brief Description of Training Request
Target Audience Training:
Anticipated Attendance (number):
Topics to be Addressed:
Length of Training:
Tentative Location:
Tentative Dates:
1100 Delaplaine Court | Madison, WI 53715 | 608-263-5613 | 1-800-752-3157 | Email Us

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Funding provided by the Department of Health and Human Services, Centers for Disease Control and Prevention

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