AHC Workshop Registration

No confirmation of your registration will be mailed or e-mailed to you.

Seating is limited, so please complete this form to
let us know if you plan to attend.

Institution Name:

Name (Please select Mr. or Ms.):*
Mr. or Ms.

Position Title:

Address:*

City:*

State:*

ZIP:*

Daytime Telephone:

Fax:

E-Mail:

AHC Programs and Grants Workshop you plan to attend:


	September 7, 2010 – 10:30 a.m. to 12:00 a.m. Pima County Public Library District, Joel D. Valdez Main Library, Lower Level Meeting Room 101 North Stone Avenue Tucson, AZ 85701
	September 21, 2010 – 11:00 a.m. to 12:30 a.m. Yuma County Public Library District, Main Library, Room C 2951 S. 21st Dr. Yuma, AZ 85364

Comments:

Seating is limited, so please submit this form to
let us know if you plan to attend.

* Required

For more information,
call Erica Kinias at 602/257-0335 X26 or
e-mail ekinias@azhumanities.org.