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Homeless Youth Conference Registration
Homeless Youth Conference
Holy Cross College, Worcester
10/24/12
9:00 AM to 3:30 PM (registration begins at 8:15 AM)
To register for the conference, please fill in the following information.
1.
Personal Information
(Required.)
NAME:
AGENCY:
EMAIL ADDRESS:
PHONE NUMBER:
2.
Continuing Education Credits have been applied for, if approved CEUs will be available for Social Work and LMHC. Please select one the following:
(Required.)
Social Work
LMHC
N/A
3.
Please rank the workshops in order of preference (descriptions on flyer). We will try to accomodate your first choice, but please note this may not be possible in all cases and workshops will be assigned on a first come first serve basis.
You will be notifed of your workshop choice the day of the training.
1st Choice
2nd Choice
3rd Choice
4th Choice
5th Choice
The Impact of Transitional Living Programs
Employment, Skills and Development
DMH Community Bases Flexible Supports Serving Youth
Permanent Supportive Housing
Prevention
4.
Do you need a special accomondation to fully participate in this conference? If yes, please specify in the box below.
Yes
No
Please Specify:
If you have additional questions please email COStaffDev@massmail.state.ma.us.