Training Registration • Online • Paper • Fax

Health care providers can register for Alaska Medicaid Training online, by mail, fax or email.

Because of limited space, providers are encouraged to register early. Those who have not preregistered are welcome to attend training, however only those who have registered are guaranteed a seat.

Complete the online registration form (below).
Print, complete and mail the paper registration form:

Class Registration • Online

Online Registration | Please complete the participant information. For multiple participants from the same organization, please register one participant at a time.

denotes required fields
Provider/Submitter Number: (enter 9999999 if you do not have a Provider or Submitter number)
Organization Name: (required if no Provider or Submitter number)
Participant First Name:
Participant Last Name:
Telephone Number: / - (example: 555/555-5555)
Fax Number: / - (example: 555/555-5555)
E-mail Address: (example: someone@domain.com)
Mailing Address 1:
Mailing Address 2:
City:
State: (please use two-character abbreviation, e.g., AK)
Zip: (example: 12345 or 123456789)

Class Registration • Paper & FAX Form

Providers can also register for classes via fax, mail or email: just print and complete the registration form:

Send it to Xerox via fax: (907) 644-9845, or
Mail it to Xerox at:

Xerox
Training & Publications Department
P.O. Box 240808
Anchorage, AK 99524-0808

If emailing your registration, scan the form, or provide all the applicant information as requested in the registration form and email it to the Xerox Training & Publications Department at anctraining@xerox.com.

After Xerox receives and processes your registration, you will receive a confirmation of the classes in which you are enrolled.

For more information, contact the Xerox Training Department 907.644.6800 or 800.770.5650 (in-state, toll-free).