REGISTRATION: Celebrating Resilience: How Peer Support Transforms Lives
Tuesday June 28, 2016 11:00-3:00 (Registration at 10:30 AM)
State House in the Great Hall (2nd Floor)

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* 1. NAME:

First Name: *

Last Name:

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* 2. Address:

Address 1

Address 2

Address 3

Address 4

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* 3. Email:

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* 4. Phone:

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* 5. Organization (if any):

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* 6. How would you describe yourself? ( You can check more than one)

Legislator or Legislative Aide

Peer Worker

Certified Peer Specialist

Peer Volunteer

Recovery Coach

Clinical or Rehab Provider

Supervisor or Administrator

MA State Employee

Researcher

Advocate, Friend, Family

Other Community Member

Details? (youth mentor, substance use advocate,etc....)

We look forward to seeing you on June 28th!
The event is in the Great Hall on the second floor of the State House. A light lunch will be provided.
If you have any questions, please call the Transformation Center at (617) 442-4111 or email us at info@transformation-center.org. Thank you!