The Transformation Center's
Western MA Community Voice Gathering
South Hadley Library
May 8, 2018

Refreshments/Social Time 9:30-10:00am
Gathering 10:00am-3:00pm

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* 1. First Name:

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* 2. Last Name:

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* 3. Address & Town:

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* 4. Organization (if any):

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* 5. Email:

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

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* 7. 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....)

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* 8. 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 The Transformation Center at (617) 442-4111 or email info@transformation-center.org.

Lunch provided
Refreshments provided from 9:30-10:00 AM. The Gathering will start at 10:00 AM and go until 3:00 PM