Registration Form for May 16-17 Workshops with Dr. Wilson

Name

First

Last

Email

How do you identify:

What language is most accessible to you?

Do you work with Deaf People in mental or behavioral health services?

Which workshop would you like to attend?

April 17th — Friday Evening Session: “Reducing Mental Health Stigma in the Deaf Community”
***This is a Deaf Only Event.***
Location:
State of Maine Building
109 Capitol Street
Augusta Maine 04330
April 18th — Saturday Session: “Destigmatizing Mental Health in Our Work as Professionals”
Location:
State of Maine Building
109 Capitol Street
Augusta Maine 04330

RID Member Number

For CEUs — This professional studies program is offered for 0.5 (5 hours) at the ‘some’ Content Knowledge Level.

CEU?

Donation

Your donation will go towards future Deaf Mental Health workshops.

behavioral Total to

Total

$0.00

Square

Card

Name on Card

Please only fill this in if you need to make a payment.

Dietary Concerns?

Any accommodation requests, comments, or questions?