Education – NBCNHU

IMPORTANT !!!

It is very important that every section of the form is properly filled out. Missing information could result in losing the opportunity to benefit from the education discounts, especially if the 45-day deadline has passed / Il est très important que chaque section du formulaire soit dûment remplie. En cas d'oubli d'informations, vous risquez de perdre l’opportunité de bénéficier des rabais d'éducation, surtout si la date limite de 45 jours est dépassée.

# Local - # Locale *

Date / Time *

Date

Time

Please indicate the date on which you took part in the training and/or convention. - Veillez indique la date auxquel vous avez participer a la formation et/ou convention

Name of the session and/or convention - Indique le nom de la formation et/ou convention à laquel votre section locale à participer *

Enter the name of each member who took part in the workshop and/or convention - Inscrire le nom de chaque membre ayant participer à l'atelier etc...

Name *

First

Last

Name

First

Last

Name

First

Last

Name

First

Last

Name

First

Last

File Upload

Please attach a photo or screenshot of proof of your local's participation in an educational session and/or convention. Ex: a registration form etc... - Veuillez joindre une photo ou screenshot d'une preuve de la participation de votre locale à une session d'éducation et/ou convention

Name