2022 MCRA Conference Registration

2022 MCRA Conference Registration
Date: *

Month Day Year
Attendee Name: *
Gender: *

Male Female
Profession: *
Organization
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
E-mail Address: *
Daytime Phone Number: *
Alternate Phone Number:
Emergency Contact Information: *

First Name Last Name
Emergency Contact Phone Number *
Have you attended this conference before? *

Yes No
If Yes, How Many Times? *
Course Selection & Payment Options

Please select from the following courses:
3-Day Course (Cannot be combined with any other courses) *

Assisting Individuals in Crisis and Group Crisis Intervention Pastoral Crisis Intervention Do Not Enroll Me in a 3-Day Course
Select a 2-Day Course (May be combined with a 1-day Course) *

Advanced Group Crisis Intervention Building Skills for Crisis Intervention Teams Do Not Enroll Me in a 2-Day Course
Select a 1-Day Course (May be combined with a 2-Day Course) *

2 The Rescue Trainings Understanding the First Responder's Culture: For Mental Health Staff Do Not Enroll Me in a 1-Day Course
Conference Fees

Conference Fees With Lodging - Includes two or three nights lodging at the RAM Conference Center, meals, and training material.

Conference Fees Without Lodging - Includes meals and training material.

*1-Day & 3-Day Course(s) begin on Sunday, September 11, 2022.

*2-Day Courses begin on Monday, September 12, 2022.
Please Select: *
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3-Day Course(s) with lodging arriving Saturday evening $ 425.00

3-Day Course(s) with lodging arriving Sunday $ 400.00

3-Day Course(s) without lodging $ 350.00

2-Day Course with lodging arriving Sunday $ 420.00

2-Day Course with lodging arriving Monday morning $ 370.00

2-Day Course without lodging $ 340.00

1-Day Course with lodging arriving Saturday evening $ 175.00

1-Day Course without lodging $ 125.00

Total $ 0.00
Requesting Social Work CEs: **Please note that there may be an additional charge for SW CE credits (available for ICISF courses only) that is separate from the conference fee you selected above that will be payable onsite the day of check in. You will be notified by email once the additional cost has been determined. *

Yes No
Roommate Request:
Please list any dietary needs or if you have a disability that may require special accommodations:
Additional Comments:
Payment Method *
Please make checks payable to MCRA

Mail payment to:

Michigan Crisis Response Assc. (MCRA)

6767 Mongtomery Road

Marlette, MI 48453
If paying via credit card, you will recieve an invoice within 24-36 hours with the credit card link to submit your payment.
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2022 MCRA Conference Registration

Course Selection & Payment Options