Fall 2016 Northeastern Regional Meeting

Fall Northeastern Regional CST Meeting
Wednesday, August 3rd, 2016, 9:00 - 3:00
Fox Valley Technical College in Appleton

Question Title

1. Please enter your contact information below.

First Name

Last Name

Tribe or County Representing

Position / Title

Agency

Address

City

State

Zip

Phone

Question Title

2. Please select the option(s) that best describe your role in the CST initiative:

CST Project / Initiative Coordinator or Director (as described in SS 46.56)

CST Care Coordinator / Service Coordinator (as described in SS 46.56)

Supervisor of CST Initiative Staff

Current or potential referral source and/or team member

Coordinating Committee member

Other (please specify)

Thank you for registering.

If you have additional questions or need to change your registration information, please contact Lori Martin at (715) 258-5430, or email: whitepine@mwwb.net.