Alternatives 2021 Registration Form

Alternatives 2022 Conference Registration Form

Virtual Conference: Join from wherever you are!
The Alternatives conference will include presentations, action groups, and networking opportunities on November 2, 3, and 4, 2022.

Thanks to our sponsors, registration is free! Everyone is welcome and donations are appreciated!

Continuing education units will not be available; but we will provide certificates of completion, which may be accepted by your credentialing board.
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 individual speakers and panels, Alternatives 2022 will include an opportunity to participate in action groups to develop goals and specific steps in key areas. In this process we hope to ignite people’s passions to work together to create change that might extend beyond the conference. If you choose to participate, which topic interests you most?

Nothing About Us Without Us--National and Statewide AdvocacyAlternatives to Coercion with an Emphasis on Peer ServicesJoining Our Struggle for Justice to the Hard-Fought Efforts of Diverse, Marginalized Groups
Would you like to volunteer during the conference? If you check yes, you will be contacted about volunteer opportunities, which include being a Zoom host, staffing the networking spaces, etc.

YesNo
Would you like to lead a networking gathering during the conference? If you are interested, indicate what topic, geographic or other area of interest you would like to invite others to join you. We will contact you with further information.
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 homelessnessMental Health ProfessionalFamily MemberOther

Registration Options*

Registration$ Free

Free

Registration with Donation$30.00

(Optional and appreciated)

Registration with Donation$50.00

(Optional and appreciated)

Registration with Donation$100.00

(Optional and appreciated)

Registration with Donation$200.00

(Optional and appreciated)

Sponsor Donation$500.00

(Recognition on website)

Sponsor Donation$1,000.00

Recognition on website and at conference

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

Questions? Donations welcome:

Email info@ncmhr.org with any questions. Additional conference information is at the website: www.alternatives-conference.org. Donations are welcome to help cover the cost of the conference: https://power2u.org/donations-ncmhr
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Alternatives 2022 Conference Registration Form