Special CTAAFSC Registration Form

CTAAFSC Registration Form

Committee Members. Presenters. Awardees. Volunteers. Network Exchange. Deadline: April 4, 2026
Event Date: April 16 -17, 2026

Venue: Greater Mt. Zion Church

4301 Tannehill Ln, Austin, TX 78721
Name

First NameLast Name
Email Address
example@example.com
Mobile Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Name of Organization/Affiliation
Conference Participation
General Admission
YesNo
1 year2-3 years4-5 years6-10 years11-20 years21+ years
Role Identification
Individual with lived experienceFamily member/caregiverParentPeer Support SpecialistBehavioral or mental healthprofessionalClergy/faith leaderStudentVeteranAdvocate/community organizerEducatorCommittee MemberPresenterAwardeeOther
PresenterCTAAFSC Planning Committee MemberAwardeeVolunteerSurvivor's BallNetwork Exchange Participant
Demographic Information
African American/BlackHispanic/LatinoWhiteAsianNative Hawaiian/Pacific IslanderNative American/IndigenousMultiracialOther
Under 1818-2425-3435-4445-5455-6465+
Conference Logistics
YesNo
YesNo
No preferenceVegetarianVegan
Food allergy or dietary restriction (please specify)
Conference Reception
YesNo
Accessibility Accommodations
ASL interpretationSpanish interpretationMobility or seating accessNo accommodations neededOther
Venue Information

The 2026 CTAAFSC will be held at a church venue. Pets and emotional support animals are not permitted on-site. CTAAFSC is committed to accessibility and inclusion, and attendees who require accommodations are encouraged to indicate their needs above so we can work to support participation.
Emergency Contact (Optional but Recommended)
Emergency Contact Name:
Emergency Contact Phone Number:
Previous attendeeWord of mouthSocial mediaOrganization or community partnerChurch or faith communityEmployer or schoolOther
Conference Agreement (Required)
Media Consent (Optional)
Yes, I consent to photography, video, and audio recording.No, I do not consent
Should be Empty:

CTAAFSC Registration Form

Conference Participation

Role Identification

Demographic Information

Conference Logistics

Conference Reception

Accessibility Accommodations

Venue Information

Emergency Contact (Optional but Recommended)

Conference Agreement (Required)

Media Consent (Optional)