REGISTRATION —
Playground Supervision Training for Child Care Providers

Learn more about the Playground Supervision Training for Child Care Providers

Please choose the session you would like in which you would like to enroll.
 

Mr. Mrs. Ms.

First Name:
Middle Initial: (Required, your middle initial is used in your username.)
Last Name:
Home Address:
 
City:
State: Zip:
Home Phone: Fax:
E-mail:
Name of Child Care Center:
Address:
 
City:
State: Zip: 
County:
Phone:
E-mail:

Type of Child Care Center
  Licensed Child Care Center
  Registered Home
  Non-Registered Home
  Other, please explain...

CEU
  Yes, I'd like CEU credit
(There is an additional $10 processing fee to receive a CEU)

Payment ...... $15

Prepayment is required. You can pay by:
Credit card (please call to give credit card information)
Purchase Order (please mail or fax)
Check (please mail)
 

Toll free number: 800-554-PLAY (7529)
Fax: 319-273-7308

Mail:
NPPS
University of Northern Iowa
Human Performance Center 103
Cedar Falls, IA 50614-0618

Additional Questions or Comments: