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Training | @

The Center

Training Registration

Introduction to Mental Health, Rehabilitation and Recovery - Fall 2008

This training will be held at the Coalition's offices located in lower Manhattan at 90 Broad St., 8th Fl. For directions please use the 'Contact Us' link on the left navigation bar.


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Session

Personal Information

* Required fields.

* First Name:
* Last Name:
* Organization:

If your agency name does not appear in drop down list, select "OTHER" at the bottom of the list and enter the name of your organization in the field that will appear below.

You must write-in your organization name:
Department/Program:
* Title:
Designation:
Ex: RN, MD, PhD, LCMS
* Address:
* City:
* State:
* Zip:
* Phone: Ext
* Email Address:

Method of Payment

Online Credit Card
Mail (check or credit card)
Fax (credit card)

Cancellation Policy

* I agree that my agency will be charged $50 if I do not cancel my registration at least 1 business day prior to the first day of training. Please email dshort@coalitionny.org to cancel your registration.