3rd Annual Blacks United in Recovery (BUR)
Presents

Blacks Addressing Mental Health and Healing to Impact Research, Policy, and Practice

Sponsored by The Transformation Center

(BUR) Summer Forum - We are registering up to 60 participants for this year's event. After #60 all who register will be added to a waiting list for this event.

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Street Address

Question Title

* 4. Town

Question Title

* 5. Organization (if any)

Question Title

* 6. Email

Question Title

* 7. Phone
If you do not share email please do include phone in case we need to contact you about event.

Question Title

* 8. Do you identify as:

Black

African American

Other (please specify)

Question Title

* 9. How would you describe yourself (can check more than one)?

Peer Worker

Peer Volunteer

Certified Peer Specialist

Recovery Coach

Clinical or Rehab Provider

MA State Employee

Supervisor

Administrator

Researcher

Funder or Policy-maker

Advocate, Friend, Family

Other community member

Details? (youth mentor, substance use advocate,etc....)

Question Title

* 10. Are you interested in learning more about mental health and the peer movement? (please tell us more about how you would like to be involved in this topic).

Question Title

* 11. Please add any questions, concerns or needs you have related to attending the event.

Thank you, we look forward to seeing you!
If you have questions, please call Valeria at 617-442-4111 x322 or email valeriac@transformation-center.org.

Light breakfast and lunch will be provided
Light Breakfast 9:00 a.m. - 10:00. a.m.
The Gathering will start at 10:00 a.m. and go until 5:00 p.m.

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Street Address

Question Title

* 4. Town

Question Title

* 5. Organization (if any)

Question Title

* 6. Email

Question Title

* 7. Phone If you do not share email please do include phone in case we need to contact you about event.

Question Title

* 8. Do you identify as:

Question Title

* 9. How would you describe yourself (can check more than one)?

Question Title

* 10. Are you interested in learning more about mental health and the peer movement? (please tell us more about how you would like to be involved in this topic).

Question Title

* 11. Please add any questions, concerns or needs you have related to attending the event.

* 7. Phone
If you do not share email please do include phone in case we need to contact you about event.