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Ohio Learning Community

Welcome to OHIO-TTAC 2013-2014

If you are an LC participant, please select your organization:

Please select your preference:

General Information:
Please complete the following demographic information.

Name: Title: Degree: Organization:
Address: City: Zip: Ohio County:
Email: Phone:    

Case To Care Information:

Type of training requested  
Number to be trained at your organization (estimated)  
Are you willing to host and allow additional attendees?  
If yes, space capacity of training room  
Request for CEU credits  
Please enter three dates in order of preference    
1st Choice  
MM/DD/YYYY  
2nd Choice  
MM/DD/YYYY  
3rd Choice  
MM/DD/YYYY  

Site Visit Information:

Specific issues for site view review  
Please enter three dates in order of preference    
1st Choice  
MM/DD/YYYY  
2nd Choice  
MM/DD/YYYY  
3rd Choice  
MM/DD/YYYY  

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