HIV/AIDS 500-501 Pre-Registration Form

HIV/AIDS 500 ONLINE and 501 ONLINE Certificates of Completion are required with pre-registration form and cannot be longer than six months prior to registration. Please send BOTH certificates and signed Participant Agreement to Registration deadline is one day prior to training date; unless training reaches capacity. A registration link via GoTo Training will be sent to all registered participants...


Testing Site Information (Datos de la institución donde se efectúa la prueba)

Participant Information (Datos del solicitante)

Name of participant’s Supervisor (Nombre del supervisor del solicitante)

Name of Certified Counselor if different from Supervisor (Nombre del Consejero Certificado si es diferente al del Supervisor)