Registration for CIAV Public Forum

1. Description of Forum

Date: Thursday, May 7, 2009
Time: 9:00am - 4:00pm EST
Location: Renaissance Mayflower Hotel - 1127 Connecticut Avenue NW - Washington, DC 20036

The forum will begin at 9:00am with a public session and presentation by the Coalition for Iraq and Afghanistan Veterans. Afternoon panels beginning at 1:00pm will feature expert panelists from CIAV organizations speaking on issues affecting our military, veterans, families, and survivors.

Please complete the form to the best of your ability. SPACE IS LIMITED.

Question Title

* 1. Demographic Information

Name: *

Company: *

Address: *

Address 2:

City/Town: *

State: *

ZIP/Postal Code: *

Country: *

Email Address: *

Phone Number: *

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* 2. Please sign up to attend a Session I panel at 1:00pm:

Post Traumatic Stress,Traumatic Brain Injury And Pain: Treating the Whole Person

Outreach and Support for Military Children

Suicide in the Military: Caring for the Surviving Families

Public, Private, and Community Partnerships

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* 3. Please sign up to attend a Session II panel at 2:30pm:

Physical and Mental Healthcare: Access to Services and Amplifing Needs

Peer Support: Helping Each Others Find a Way Home

Engaging the Media: A Look Inside Coverage of the War and Where We Go Next

Economic Health: Access to Benefits, Housing and Employment

Registration for CIAV Public Forum

1. Description of Forum

Question Title

* 1. Demographic Information

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* 2. Please sign up to attend a Session I panel at 1:00pm:

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* 3. Please sign up to attend a Session II panel at 2:30pm:

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* 4. Are there any topics related to military, veterans, families, and survivors that you would like to learn more about during this forum?

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* 5. Please describe your affiliation with or connection to a Coalition organization (if applicable).

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* 6. How did you learn about the conference?