4-13-23 Food is Medicine - Chapter

• If you have any questions about registration, please contact NASW-FL at 850-224-2400 / 1-800-352-6279 or email: info.naswfl@socialworkers.org

Personal Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• Address 1:
• City:
• State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• ZIP Code:
• * Phone:

• ATTENTION LICENSEES: If you are licensed in Florida, your credit will automatically be entered into the CE Broker tracking system, provided you list your license prefix (SW, MH, or MT) and your correct license number. If you are licensed in another state, please indicate the state along with your license number. In all cases, it is the licensee's responsibility to provide an accurate license number when they sign in at the workshop. If you are unsure of your license number at this time, leave the space blank and you can self-report your CEs.

• License Number:

• Fee

  Type	Fee
  NASW / AND Members	No Charge
  Non-Members	$10.00