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NAMI Vermont Family-to-Family Registration
At this time, we can only accept registrations for Barre/Montpelier area, Brattleboro, or Williston. *
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First Name *
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Last Name *
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Address *
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City/Town *
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State *
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Zip *
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County
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Phone Number(s) *
(Please provide the best number to reach you and the best time of day to call)
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Email Address *
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How did you hear about us? *
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Are you a family member, close relative or friend of person who is living with a mental illness *
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What is the relationship to this person? *
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What is their primary diagnosis? *
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Does this person live nearby or with you? *
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Why are you interested in attending the Family-to-Family class or what are your objectives in attending? *
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Do you need special accommodations?
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Thank you for your interest in the Family-to-Family class. Please note that this form does not confirm your registration. We will contact you soon to discuss the registration process.
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