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T-TAP Regional Training Registration Step 1
 
For which training would you like to register?
 
Billing Information
Fields marked with a red asterisk (*) are required.
 
*How many training participants are you registering? 
*How would you like to pay? 
  Credit card
Please download your preferred format of the following form
and FAX it to the attention of
Dita Batteau at 804-828-2193: MS Word | Rich Text | Plain Text
  Check
After filling out and submitting all information, please print out
the confirmation page and mail it, along with your check made payable
to Virginia Commonwealth University / RRTC, to:

Dita Batteau
VCU-RRTC
PO Box 842011
Richmond, VA 23284-2011
  Purchase Order
To pay via purchase order, please either:
  1. Fill out and submit all participant and billing information, then print out the confirmation page and FAX it, along with a copy of your purchase order, to the attention of Dita Batteau at 804-828-2193; or
  2. Email Dita Batteau at dcbattea@mail1.vcu.edu.
*Agency: 
*Contact First Name: 
*Contact Last Name: 
*Contact Phone: 
format: 999-999-9999
Contact Fax: 
format: 999-999-9999
*Contact Email: 
*Billing Address 1: 
Billing Address 2: 
*City: 
*State: 
*Zip/Postal Code: 
*Country: 
  Please check here if your mailing and billing addresses are NOT the same.
 
 
T-TAP is funded by the Department of Labor (DOL), Office of Disability Employment Policy (ODEP) cooperative agreement # E 9-4-2-01217. The contents of this site do not necessarily represent the interpretations or opinions of DOL. Virginia Commonwealth University, is an equal opportunity/affirmative action institution providing access to education and employment without regard to age, race, color, national origin, gender, religion, sexual orientation, veteran's status, political affiliation, or disability. Privacy Policy. If special accommodations or language translation are needed contact Katherine Inge at: kinge@atlas.vcu.edu or Voice (804) 828 - 1851 | TTY (804) 828 - 2494.