Registration Form Please, select the virtual class you wish to attend. Instructor: Donna VanPeursem Sessions*Leadership Development Seminar Employer* Your Name* Your Email* Training Date: please select a date*Tuesday, Jan. 25: 8:30am-11:00amThursday, Jan. 27: 8:30am-11:00amThursday, Jan. 27:1:00pm-3:30pmTuesday, Feb. 1: 8:30am-11:00amMonday, Feb. 7: 8:30am-11:00amTuesday, Feb. 15: 8:30am-11:00amTuesday, Feb. 15: 1:00pm-3:30pmTuesday, Feb. 22: 8:30am-11:00amTuesday, Feb. 22: 2:00pm-4:30pmWednesday, Feb. 23: 1:00pm-3:30pm Please register each manager or supervisor attending the training* Enter each name on a separate line. Enter the number of total registrants* Choose Registration Rate*EAP Plus Customer (Complimentary)Non-Customer Rate ($94.95 / Person)Connections EFS or EFS/BRM Rate ($65.00 / Person) Total Amount* By typing your full name here, you approve the above registrations for leadership staff.* Employers (non-customer rate) that do not have the Connections Inc. EAP Benefit, must submit registration and payment by mail two weeks prior to training date. For Connections customers: If payment is not received along with the registration form it will be invoiced and added to the regular billing statement from Connections Inc. Employee Assistance Program.