CFAL Registration Form

Florida Department of Elder Affairs
and
The Big Bend Fraud Task Force

2012 Fraud Prevention Seminar Registration

Tuesday, March 27, 2012
9:00 a.m. to 11:30 a.m.
The Early Learning Coalition
1940 N. Monroe Street, Suite 700
Tallahassee, FL 32303

Lunch provided with registration.
Registration closes on March 20, 2012, 5:00 p.m.

Big Bend Fraud Task Force Logo

Contact Information: (Fields required are marked with *)

Prefix:

*Last Name:

*First Name:

Organization:

Title:

*Mailing Address:

Address Line 2 (optional):

*City:

*State:

*Zip Code:

*Telephone Number (with area code):

Fax Number (optional):

*Email:

The seminar is designed to empower and increase citizen awareness in our community.

Click the following link for direction to the Early Learning Coalition. (You will arrive at the Google Map Web site, where you will enter your starting locaion.)

For additional information, please call Allison Bryant at 850-414-2072 or via email bryanta@elderaffairs.org.