The Way Home Registration
Please Select One:
I'd like to register for the workshop.
I cannot attend, but would like to talk with a Dollar Bank representative about the program.
First Name
Last Name
Address
Address Line 2
(Optional)
City
State
Pennsylvania
Maryland
ZIP Code
(5 digits)
Phone
(Include area code, 10 digits)
Email Address
How did you hear about our workshop?:
Select One
TV
Radio
Social Media
Newspaper
Community Organization
Bus
Billboard
Friend
Church
Dollar Bank Office
Dollar Bank Website
Do you require child care while you are attending the workshop? If yes, please click the +Add Child button below to add each child's name, age and any special needs including food allergies. Please Note: Child care availability is limited. Child must be able to use restroom facilities without assistance.
Dynamic Child Records
Children Requiring Child Care (
Up to Five Children)
+ Add Child
For accessibility accommodations during the workshop please contact Cheryl Johnson at 412-261-8109.
Submit