Sustaining Individualized Options  during Challenging Times

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REGISTRATION


Fee: Fee for registration is $50.00; for Family members $25.00.  The fee(s) are non-refundable.
 
CEUs:  Social Work and Mental Health CEUs will be available at no charge.  Nursing contact hours will also be available, at no charge.  For further information, please contact Anita  at 1-508-653-8724 x227.
 
 
Workshop Choices  
   
     Morning (101-104)  
     Afternoon (201-205)  
      
   
Credits  
Will you want to receive CEUs?  
Will you want to receive RN hours?  

 


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Personal Information  
First Name  
Last Name  
Agency  
Address  
Phone  
E-mail  

 


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Additional comments

 

 

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Registration Fee  
Payment method
 
 
If paying by check:  please make payable to "Shared Living Conference," and mail to:

     Connie Topor

     Shared Living Conference

     P.O. Box 158

     Sturbridge, MA  01566

If paying by credit card: please call Connie Topor at 1-800-652-2201 x150 or FAX at 1-413-732-1168
  

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