AAVC Virtual Lecture Series Registration -- Unit 3 Session 3: The Community Resiliency Model: An Introduction

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* 1. Email Address

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* 2. First Name

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* 3. Last Name

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* 4. Organization

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* 5. National Provider Identifier (Non-providers type in "NA")

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* 6. What is your race? (Select all that apply)

White

Black or African American

American Indian or Alaska Native

Asian Indian

Cambodian

Chinese

Filipino

Hmong

Japanese

Korean

Laotian

Vietnamese

Native Hawaiian

Guamanian or Chamorro

Samoan

Other (please specify)

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* 7. Are you Hispanic, Latino/a, or Spanish origin

Yes

No, not of Hispanic, Latino/a, or Spanish origin

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* 8. Please select

N/A, not of Hispanic, Latino/a, or Spanish origin

Mexican, Mexican American, Chicano/a

Salvadoran

Cuban

Guatemalan

Puerto Rican

Other Hispanic, Latino, or Spanish origin:

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* 9. Do you want to earn continuing education for your participation in this session? (Choose all that apply)

Continuing Medical Education for Physicians (CME)

Maintenance of Certification for Physicians (MOC Type 2)

Continuing Education for Psychologists (CE) *LIVE session only

Continuing Education for LMFTs, LCSWs, LPCCs, and LEPs (CE) *LIVE session only

Continuing Education for Registered Nurses (CE)

None