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HHHA Online Employment Verification
Orientation Workshop Registration Form

*Must Complete Entire Form

Agency Name:
 
Agent Contact Person:
 
Telephone Number:
 
E-Mail Address:
 
Total Number of Attendees:
 
Please choose the event you would like to attend below: (Note: A final count will need to be provided to the facility one week prior to the event.)
 
June 20, 2012
Trayes Hall A, Douglass Campus Center,
100 George Street, New Brunswick, NJ

Directions/Location Info
 
10:30am
 
1:30pm

June 27, 2012
Trayes Hall A, Douglass Campus Center,
100 George Street, New Brunswick, NJ

Directions/Location Info
 
10:30am
 
1:30pm

Online verification is the mechanism the Board will use going forward to determine the HHHA eligibility status for future renewals. Your continued support of this process is appreciated.

           

 

   
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