2023 MCRA Conference Registration

2023 MCRA Conference Registration

September 10-12, 2023
Date:*

MonthDayYear
Attendee Name:*
Gender:*

MaleFemale
Profession:*
Organization
Address*

Street Address

Street Address Line 2

CityState / Province

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

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

YesNo
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 InterventionDo Not Enroll Me in a 3-Day Course
Select a 2-Day Course (May be combined with a 1-day Course)*

Grief Following TraumaManaging School CrisesFrom Trauma to AddictionsFirst Responder Peer Support TrainingDo Not Enroll Me in a 2-Day Course
Select a 1-Day Course (May be combined with a 2-Day Course)*

Psychological Body ArmorSuicide AwarenessCISM Refresher CourseMental Health First Aid for First RespondersDo 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 10, 2023.

*2-Day Courses begin on Monday, September 11, 2023.
Please Select:*
prevnext( X )
Full Conference (3-Days) with lodging arriving Saturday evening$425.00

Full Conference (3-Days) with lodging arriving Sunday$375.00

Full Conference (3-Days) without lodging$325.00

2-Day Conference with lodging arriving Sunday$375.00

2-Day Conference with lodging arriving Monday morning $350.00

2-Day Conference without lodging$325.00

1-Day Conference with lodging arriving Saturday evening$175.00

1-Day Conference without lodging $150.00

Total $0.00
Requesting Social Work CEs: **Please note that there may be an additional charge for SW CE credits 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.*

YesNo
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
Should be Empty:

2023 MCRA Conference Registration

Course Selection & Payment Options