My Personal Profile

Welcome, Kathryn DeBroux

Your application was submitted on 5/1/2015.
You have completed the online portion of the application.
Please review the information below for details on payment or documentation required to proceed.

Become a Registry Member - $50.00

Add a Trainer Endorsement - $15.00
Add a Consultant Endorsement - $15.00
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Application Submission Fee:

Your Registry application fee has not yet been received. If you sent a check, please allow two to three weeks
for payment processing. Otherwise, you can pay online now.

Invoice:
Status:
Amount:

112628-20150501-2
Unpaid
$50.00

Invoice Payment:
Coupon Code:

Apply

Documentation Pending
The next step toward completing the process is for you to send us verification documents. Your Registry ID number is
112628. Please include your Registry ID number on all verification documents.
You have until 5/11/2015 (10 days) to send in the following documentation:

Membership
1.
2.
3.

High school diploma (if you did not attend college)

College transcripts
o Associate: Elementary Education - University of Phoenix
o Associate: Early Childhood - Northeast Wisconsin Technical College
Certificates
o AED - Automated External Defibrillator - American Heart Asscociation
o Child CPR - American Heart Asscociation
o DCF - Shaken Baby Syndrome - Northeast Wisconsin Technical College
o DCF - SIDS Training - Northeast Wisconsin Technical College
o First Aid - American Heart Asscociation
o Infant CPR - American Heart Asscociation

Next Steps:
Put all of your documents in one envelope and mail it as soon as possible to:
The Registry
Document Verification Department
5900 Monona Drive
Suite 205
Madison, WI 53716