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Active Shooter Awareness

Payment

Registration fee: $35.00 per person must be received prior to registering to be considered registered for the seminar. Preference given to early registrants.

Make checks payable to Monroe Community College.

Send completed registration form and check to:
Sheila Manns
Homeland Security Management Institute
1190 Scottsville Road, Suite 100J
Rochester, NY 14624
Phone: 585.753.3921

Contact Information

Social Security Number:		(999-99-9999)
First Name:
Middle Initial:
Last Name:
Ethnic Origin:
Medical Information:
Name of Organization:
Job Title:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone Number:
E-mail Address:
Fax Number:

You will receive an acknowledgement from Monroe Community College via email. Please follow the instructions in the email to complete the registration process.