We, the undersigned do hereby attest to the fact that we

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LYDIA / Safe Families for Children, Northwest Indiana

(219) 741-0569 P.O. Box 433 Cedar Lake, IN 46303

TRAINING COMPLETION

We, the undersigned do hereby attest to the fact that we have completed the Safe Families For Children

Training DVD/web-site curriculum. We understand that this training may not be comprehensive of every situation we may encounter and are willing to seek further information as the need arises.

We would appreciate any feedback you have to offer on this training:

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Signed:

__________________________________ ____________________________________

Printed Name Printed Name

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Signature Signature

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Date Completed Date Completed

Please mail this form to the above address.

OR

E-mail to safefamiliesnwi@yahoo.com

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If you are e-mailing this form, your name typed in ‘signature’ is representative of an electronic signature.

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