Annual Training | Health and Human Services North Dakota

Name

Organization

Phone

Do you need accommodations while at the training? Please describe below:

Please list any allergies or dietary needs:

Payment Instruction

DPI, Job Service, WSI, DOCR, Career and Technical Education, and Dept. of Commerce, HHS Employee - Registration postmarked on or before October 6, 2023

$130 per person - Registration postmarked on or before October 6, 2023

$140 per person - Registration postmarked after October 6, 2023

Payment Enclosed (Checks payable to ROND) No refunds

Submit payment to:

Cheryl Anderson
Vocational Rehabilitation
1000 East Divide Ave
Bismarck ND 58501
Or email: cheanderson@nd.gov if you have any questions