annconebpform

ANNUAL CONFERENCE EVIDENCE BASED PRACTICES SEMINAR
PRE-REGISTRATION FORM

If you would prefer to submit by mail, please click here.

First Name:

Last Name:

Address:

State:

City

Zip

Phone:

Affiliate:

Email:

Fax:

County:

Session(s) you wish to attend:

Family Members with Young Children
with Mental Illness
9:30 am - 12:00 pm

Children's Commission on Children
and Families, State Officials and
Providers (by invitation)
1:00 pm - 3:00 pm

Models for Change
(by invitation)
3:30 pm - 5:30 pm

Names of additional attendees:

Radisson Penn Harris Hotel, Harrisburg PA

"Today's Family and the Faces of Mental Illness:
A Life's Journey."