Event Registration

Completing this form will send your request for registration to the Michigan PMTO State Office. You will receive a confirmation email once your registration has been accepted. Please note: not everyone is eligible for all PMTO events. Completing this form does not guarantee your acceptance to the event.

Michigan PMTO will never sell the information you provide here. This information will be used for registration purposes only.

If you have any questions before you register or if you need help completing this form, please contact us.

Event I’m registering for:

Agency/Organization:

Job Title:

First Name:

Last Name:

Email:

Phone:

Special Accommodations:
Please indicate in the box below if you have any dietary needs (vegetarian, nut allergy, etc.) or other special accommodations you would like the event organizers to know.

I consent to being recorded and/or photographed during this event. I consent to allowing Michigan PMTO to use video of me, my image, and/or my voice for training and educational purposes. (Michigan PMTO will not use this material for advertising.):

I Agree

I grant consent for Michigan PMTO to collect and record my personal information provided in this form. This information will only be used for event registration and follow up purposes and will not be used for any other purpose:

I Agree