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Last Updated: 2-December-2008
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Please indicate your 1st and 2nd choice on the form and email with a completed application form. Confirmation will be sent by e-mail. In order to have an effective training session, a minimum class size of 5 is required.
First Name:
Last Name:
Phone Number:
Email:
1st choice Date and Time:
2nd choice Date and Time:
T-shirt size:
   
 


 
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Rappahannock-Rapidan Medical Reserve Corps
640 Laurel Street
Culpeper, Virginia 22701
540.829.7350, ext. 132 - phone
540.829.7345 - fax
RRMRC@vdh.virginia.gov


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© Copyright 2004 Rappahannock-Rapidan Medical Reserve Corps. All rights reserved.