WRAP Registration Form

Registration Request Form

This registration request form is intended to request registration for the 4-day Wellness Recovery Action Planning (WRAP) workshop that will take place on Mondays, April 16, 23, 30 and May 7th at the RLC's Bowen Center in Springfield.

This workshop is intended for anyone who is interested in learning more about the basics of WRAP and creating their own WRAP plan.

Please note: Space is limited and this form is just intended as a REQUEST to register. You should not consider yourself officially registered until you receive a confirmation.

This WRAP workshop is free and being offered through the RLC by WRAP facilitators, Chris Carlton and Martha Barbone.

Question Title

* 1. Please complete the contact information below.

Name *

Company

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country

Email Address *

Phone Number *

Question Title

* 1. Please complete the contact information below.

Question Title

* 2. Please tell us a bit about why you are interested in taking this WRAP class.