CDS Seattle, WA Training Information Form

[contact-form to=’info@cldisasterrelief.org’ subject=’CDS Seattle Registration’][contact-field label=’Last name, First name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Address’ type=’textarea’ required=’1’/][contact-field label=’Phone #’ type=’text’ required=’1’/][contact-field label=’Affiliation’ type=’text’/][contact-field label=’Child life status’ type=’select’ options=’CCLS,CLS,CLA,CL student,Other’/][contact-field label=’Employment status’ type=’select’ options=’Full-time,Part-time,PRN (as needed),Student,Retired,Other’/][contact-field label=’Are you a member of PWNCLA?’ type=’checkbox-multiple’ required=’1′ options=’Yes,No’/][/contact-form]