Mental Illness and Recovery Registration Form
Please register me for the following Mental Illness and Recovery workshop:
Suggest other towns 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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