Please complete registration form below for EACH
participant: (Register each participant separately.)
Please note that ALL fields are required to submit
registration.
contact
(
indicates link available)
Susan Karlins, MPH
BANPAC Coordinator
E-mail Susan Karlins
Tel: 408.793.2720
Fax: 408.793.2731
1400 Parkmoor Ave.,
Ste 120B,
San Jose, CA 95126