Center for Public Health Practice
Colorado School of
Public Health
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Answering the questions below will set up an account for you, making it quick and easy to sign up for future trainings, and giving you a record of all trainings you've registered for. Your answers are kept internal and will not be shared with outside entities.
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First Name
Last Name
Address 1
Address 2
City
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State
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Zip
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Alaska
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Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
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Phone
Cell Phone
Okay to text last-minute course updates?
Profile Photo
Organization/Employer
Job Title
Gender Identity
Select Gender Identity
Different Identity
Female
Male
Prefer Not to Respond
Age
Select Age Group
Under 20
20 - 29
30 - 39
40 - 49
50 - 59
60 and Older
Which of the following best describes your race/ethnicity?
Select Ethnicity
American Indian or Alaskan Native
Asian
Black or African American
Hispanic or Latino
Multiracial
Native Hawaiian or Other Pacific Islander
White
What closely describes your focus area/occupational classification?
Select Focus Area
Community Health Center
Dental
Emergency Preparedness
Environmental Health
Epidemiology/Biostatistics
Health Administration
Laboratory Sciences
Mental Health
Nurse
Nutrition
Other
Physician
Public Health
Public Health Law
Public Health Nursing
Public Health Policy
Social Work
Student
Veterinarian
What is your highest level of education completed?
Select Education Level
High School or GED
Some college coursework but not degree
Degree from a Technical School
Associate's degree
Bachelor's degree
Master's degree
Doctoral degree
Other Profession
How long have you been in this profession?
Select Time in Profession
Less than 6 months
6 months to almost 1 year
1-3 years
4-5 years
More than 5 years
What closely describes your agency?
Select Agency Type
Academia
Cancer Center
Clinic or Community Health Center/Private Practice
Community-Based Organization/Agency/Non-Profit
County Health Department
Health Department
Health Plan, RCCO or Insurer
Hospital
Local Public Health Department
Other
Other Government Agency
Patient Care
State Health Department
Other Agency Type
What best describes your work setting(s)?
(select all that apply)
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