Registration Form Stalking Investigative and Intervention Strategies A Victim-Centered Approach A one-day training sponsored by George Mason University Sexual Assault Services March 25, 2011, 8:30 am – 4:00 pm George Mason University, 4400 University Drive, Fairfax, VA, 22030 Student Union Building II, Rooms 5, 6, and 7 Name: __________________________________________________________________________ Title: ___________________________________________________________________________ Organization: ____________________________________________________________________ Street Address: ____________________________________________________________________ City: _____________________ State: ______________ Zip Code: _____________ Telephone: _________-_________-___________ Fax: _________-_________-___________ Email: __________________________________________________________________________ Registration fee includes training, light breakfast, coffee, lunch, and snacks. ____ $25 Non-George Mason University Organizations (check or cash) ____ $20 George Mason University Community Members (cash, check, or journal voucher) Do you require a parking pass? If so, it will be provided at the training. ____ Yes Registration form and full payment must be received by March 21, 2011. Please make checks payable to George Mason University (Federal ID #54-0836354). Send Completed Registration with Payment to: Sexual Assault Services MSN 2B2 George Mason University 4400 University Drive Fairfax, VA 22030-4444 Directions will be sent in a confirmation e-mail upon receipt of your registration. Six hours of DCJS Law Enforcement Career Development Credit is available. For further information or an agenda, please contact Connie Kirkland (email@example.com, 703-993-4364). If you require special accommodations please contact George Mason University Sexual Assault Services at 703-993-4364 by March 21, 2011.
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