Region I Family Planning Training Registration Fall 2008 To register, please provide the following information, select the training(s) you wish to attend and click the "submit" button at the bottom of the page. A page will load confirming we have received your registration. * indicates a required field *NAME:   JOB TITLE:   *AGENCY or CLINIC NAME:   ADDRESS:   CITY:   STATE:   CT MA ME NH RI VT Other (write in) *WORK PHONE:   FAX NUMBER:   *^E-MAIL:   ^Please provide your email address so that we may send you a confirmation message (will arrive within 7 days of the training)

PLEASE CHECK THE TRAINING(S) FOR WHICH YOU ARE REGISTERING:   3/13/08: Title X Confidentiality: Legal, Medical, and Financial Issues $15.00 for RI Title X clinics staff; $20.00 for staff from other Title X clinics. For non-Title X funded programs the fee schedule is as follows: $60.00 for staff from a non-profit agency and $110.00 for staff from a private agency. 3/20/08: Female & Male Genital Dermatology in the Reproductive Healthcare Setting Free! 4/1/08: Providing Culturally Competent Male Services $15.00 for Tapestry staff; $20.00 for staff from other Title X clinics. For non-Title X funded programs the fee schedule is as follows: $60.00 for staff from a non-profit agency and $110.00 for staff from a private agency. 4/16/08: HIV Rapid Testing & Family Planning Training at maximum capacity: Registration closed. $15.00 for Health Quarters staff; $20.00 for staff from other Title X clinics. This training is not open to staff from other agencies at this time. 4/23/08: Contraceptive Update Webcast Free! 4/28/08: Creating a Health Care Model $15.00 for PPNNE staff. This training is not open to staff from other agencies at this time. 5/7/08: HIV Integration: Moving Toward the CDC Recommendations for HIV Testing in Healthcare Settings Free! 5/14/08: Delivering Clinical, Outreach, and Educational Services to Males $15.00 for FPAM staff; $20.00 for staff from other Title X clinics. For non-Title X funded programs the fee schedule is as follows: $60.00 for staff from a non-profit agency and $110.00 for staff from a private agency. 5/16/08: Old Methods: New Information $15.00 for Health Awareness staff; $20.00 for staff from other Title X clinics. For non-Title X funded programs the fee schedule is as follows: $60.00 for staff from a non-profit agency and $110.00 for staff from a private agency. 5/22/08: At Risk - Beginning Signs of Addiction $15.00 for NH Title X staff; $20.00 for staff from other Title X clinics. For non-Title X funded programs the fee schedule is as follows: $60.00 for staff from a non-profit agency and $110.00 for staff from a private agency. 6/5/08: Teens and Technology: Using New Media to Communicate With Our Clients Free!

Total Fee: Title X Staff can check here to request that their agency be directly billed for the training fee Registration fees are refundable if cancellations are received ten days prior to the workshop. Substitutions are allowed if prior notification is received. Payment is expected on or before the training if the Title X agency is not being billed. Payment must be in cash, check or money order. We are unable to accept credit cards at this time. Please do not send cash in the mail. Thank you. Please make checks payable to JSI Research & Training Institute, Inc.   JSI would like to make every effort to accommodate participants with special needs. Please indicate your specific need(s), including dietary below.

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Should you have questions about registration or the upcoming trainings, please contact the JSI staff person provided below. Leah Nigro JSI Research & Training Institute Region I Title X Family Planning Training Center 44 Farnsworth Street Boston, MA 02210-1211 (p) (617) 482-9485 (f) (617) 482-0617 lnigro@jsi.com