Please use this form to confirm your attendance at the Regional Emergency Mental Health Summit on Monday, October 13, at IBEW Local 48 in Portland. The event will run from 9:00 AM – 4:00 PM with breakfast at 8:00 AM and an optional dinner following at Migration Brewing.

Box lunches will be provided during the midday discussion.

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* 1. Please enter your full name:

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* 2. Company/Organization:

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* 4. Please indicate if you will attend the dinner at Migration Brewing after the summit.

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