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External Applicant Registration Form
To enroll in one of the IERHA Education sessions, complete the form below and submit it to The IERHA Regional education department will contact you upon receipt of you application to confirm spot availability an process payment; payment is required to secure a spot in the session.

To complete the form electronically, click here. (Microsoft Word Form)

To access the printable version, click here (PDF).

Questions/ Comments?

Contact us at:  204-785-4760

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