EHAP Workshop Online Registration

To enroll in the EHAP Workshop, please fill out the registration form below.

The fee for enrollment in the workshop is $85 for members and $100 for non-members.

To ensure your reservation, please register by November 8, 2024.

REGISTRATION IS LIMITED.

Attendees will be accepted on a first-come, first-served basis, determined by receipt of the enrollment fee or the PO. All registrants will receive a post card indicating whether they are in the class. If you do not receive notification, please call CTPA to verify that you are included in the class.

If you work for a municipality and would like to submit a Purchase Order, please use the flyer registration form and mail it to CTPA with your PO number.

If you have any questions, please call the CTPA office at 203-484-2512.

EHAP Registration Form

Name*
First Last
Company / Organization
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Daytime Phone Number
Addition Names
EHAP CTPA Member Registration Quantity
Price: $85.00
EHAP Non-Member Registration Quantity
Price: $100.00
Total
$0.00
Consent*
I understand there are no refunds or credits for a later class or monies towards membership dues.
I agree to the privacy policy.
Credit Card Information*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Name
This field is for validation purposes and should be left unchanged.

EHAP Registration Form

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