Mental Illness and Recovery Registration Form
Please register me for the following Mental Illness and Recovery workshop: *
Suggest areas where you would like to attend under "Other". All workshops will be held on a Saturday from 9:00 a.m.-4:00 p.m.
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
ZIP *
Your answer
Email Address: *
(Required to send confirmation and directions)
Your answer
Phone: *
Your answer
How did you hear about the Mental Illness and Recovery workshop?
Your answer
What are your objectives with participating in the workshop? What do you hope to learn?
Your answer
Submit
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