Alternatives 2021 Registration Form

Alternatives 2021 Conference Registration Form

Virtual Conference: Join from wherever you are
The Alternatives conference will include workshops, and action groups, and evening events on July 8, 10, 15, and 17, 2021.

Registration without CEs is free of charge.

Registration which includes CEs (continuing education units) from NASW is $30. Workshop registration and attendance will be tracked.
Name*

First NameLast Name
Group/Organization:
State/Country:*
Email*
example@example.com
Special Considerations/Translation needs (closed captioning, etc.):
Have you attended an Alternatives Conference previously?*

YesNo
In addition to workshops, Alternatives 2021 will include an opportunity to participate in action groups to develop goals and specific steps in key priority areas. In this process we hope to ignite people’s passions to work together to create change that might extend beyond the conference in the days, weeks, and months ahead. If you choose to participate, which topic interests you most?

National and Statewide AdvocacyCrisis Prevention and Alternatives to InstitutionalizationPromoting Racial and Social Justice
Would you like to volunteer during the conference? If you check yes you will be contacted about volunteer opportunities which includes being a zoom host assistant for workshop presenters.

YesNo
How do you identify? Please mark all that apply. (This section is completely voluntary).

Mental Health Consumer/Survivor/PeerLived experience of substance use/addictionYouth/Young adultLatinxAsian/Pacific IslanderAfrican American/BlackNative American/Alaska NativeMore than one raceLGBTQ+VeteranPerson with disability (PWD)Person who has experienced homelessnessMH ProfessionalFamily MemberOther

Registration Options*

Registration with CEs (Continuing Education Units)$30.00

Registration without CEs (Continuing Education Units)$ Free

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Registration by check or purchase order:

Email info@ncmhr.org for instructions if you would like to pay by check or purchase order. Additional conference information at the website: www.alternatives-conference.org. Donations are welcome to help cover the cost of organizing the conference. https://power2u.org/donations-ncmhr
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Alternatives 2021 Conference Registration Form

Registration by check or purchase order: