Trauma Stewardship DVAC Conference Survey

Trauma Stewardship: Caring for Self While Caring for Others
By: Laura van Dernoot Lipsky

Laura is a trauma social worker and an educator with 24 years of experience. She is the author of the insightful book Trauma Stewardship, an everyday guide to caring for self while caring for others.

Laura’s experience includes front-line work with homelessness, domestic violence, sexual assault, child abuse, the sex trade, natural disasters, environmental destruction, first response, law enforcement trauma, and with those who work in the helping professions.

Please join us at our 12th Annual Domestic Violence Advisory committee Conference on October 25th, 2011 at Hodel's! Seating is limited to the first 250 registrant.

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1. Please share your contact information (verify spelling for certificate of attendance; if registering for multiple people, please fill up this survey for each person, providing the information below.)

Please share your contact information (verify spelling for certificate of attendance; if registering for multiple people, please fill up this survey for each person, providing the information below.) Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP:
Email Address:

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2. The cost for the training is $25.00, which covers continental breakfast and lunch (All cancellations must be submitted in writing 5 days prior to event. Please make checks payable to DVAC). Pre-registration for the training is preferred for the availability of certificate and advance payment is desired. I plan to:

The cost for the training is $25.00, which covers continental breakfast and lunch (All cancellations must be submitted in writing 5 days prior to event. Please make checks payable to DVAC). Pre-registration for the training is preferred for the availability of certificate and advance payment is desired. I plan to: Drop off Payment at the Alliance, 1921 19th St, Bakersfield 93301

Mail in Payment to: DVAC, c/o Raye Bugnosen, 1921 19th St, Bakersfield 93301

3. Are there any questions you would like to be addressed by the speaker at this event?

Are there any questions you would like to be addressed by the speaker at this event?

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4. DVAC has trainings, meetings and special announcements from time to time, would you to like to receive this information via email?

DVAC has trainings, meetings and special announcements from time to time, would you to like to receive this information via email? Yes

No

5. Signed books by the author are available at the discounted price of $12.00 per book, Amazon sells it at $20.00 unsigned, list price. How many would you like to reserve?

Signed books by the author are available at the discounted price of $12.00 per book, Amazon sells it at $20.00 unsigned, list price. How many would you like to reserve? No Thank You.

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6. How did you hear about this event?

How did you hear about this event?

7. Do you have any comments or questions about the event?

Do you have any comments or questions about the event?

Thank you for your time.

Raye Bugnosen M.A. ED Psych
DVAC President 2011
Clinical Services Manager
Alliance Against Family Violence and Sexual Assault
wk: 661-322-0931
email: rbugnosen@aafvsa.org

Trauma Stewardship DVAC ConferenceExit this survey

*1. Please share your contact information (verify spelling for certificate of attendance; if registering for multiple people, please fill up this survey for each person, providing the information below.)