REGISTRATION
The Transformation Center's 2017 Community Voice Gatherings
Peer Support: A Profession on the Move ~ Making Waves Toward the Future

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* 1. First Name:

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* 2. Last Name:

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* 3. Address:

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* 4. Email:

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* 5. Phone:

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* 6. Gathering(s) you are registering for:

April 19, 2017 - Arlington Public Library, 700 Massachusetts Avenue (Robbins Community Room).
9:45-10:30 am Registration & Coffee 10:30am-4:00pm Gathering

May 8, 2017 - Worcester Public Library - 3 Salem Square, Worcester, MA (Saxe Room)
9:45-10:30 am Registration & Coffee 10:30-4:00 Gathering

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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....)

Thank you, we look forward to seeing you at the regional gathering!
If you have questions, please call Catherine Quinerly at Transformation Center at (617) 442-4111 or
email catherineq@transformation-center.org.

Lunch provided, Registration is from 9:45 -10:30 AM. The Gathering will start at 10:30 AM and go until 4:00 PM