Thank you for taking the time to let us know whether you’ll be able to join us at this empowering training.

Location:  CAARE, Inc. (a nonprofit community health organization)
214 Broadway Street
Durham, NC 27701
Date:  July 13, 2019
Time:  9 a.m. to 12 p.m.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your email address?

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* 4. What is your phone number?

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* 5. Where do you reside?

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* 6. Are you a NAMI member?

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* 7. If you ARE NOT a NAMI member, would you like information on how to become a member?

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* 8. If you ARE a NAMI member, which affiliate are you a  member of?

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* 9. If you are bringing additional people with you to the PADs training, please list how many people including yourself will be attending?

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