CASAT - Prevention, Intervention, Treatment, Recovery
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2009 Saying It Out Loud (May 08, 2009)

Participant Contact Information

First Name:
Middle Name / Initial:
Last Name:
Title:
Organization:
Street Address:
City:
State:
Zip Code:
Phone Number: (include area code)
Fax Number: (include area code)
Participant Email Address: (will receive confirmation)
Confirm Participant Email:
Send Copy of Confirmation
To This Email Address:

(in addition to participant confirmation email)


Participant Registration Information

Primary Employment Type(s): Check ALL that are applicable. If your primary employment type is not listed, add it in the 'Other' field.

Chemical Dependency
Counselor
Mental Health
Intervention
Prevention
Social Services
Social Worker
Vocational Rehabilitation
Student

 Other:
Employer(s): Check ALL that are applicable. If your employer is not listed, add it in the 'Other' field.

King County Mental Health Chemical Abuse and
     Dependency Services Division
Tacoma/Pierce County Health Department
Seattle Counseling Services
Center for Human Services
DSHS - Division of Alcohol and Substance Abuse
DSHS - Division of Child Support
DSHS - Diversity Affairs
DSHS - Division of Developmental Disabilities
DSHS - Home and Community Services Division
DSHS - Indian Policy and Support Services
DSHS - Juvenile Rehabilitation Administration
DSHS - Mental Health Division
DSHS - Residential Care Services
DSHS - Division of Vocational Rehabilitation

 Other:
Lunch Choice: Meat Sandwich Vegetarian Sandwich
Conferences Attended:
Special Accommodations: Please specify any special needs, accommodations, or dietary needs.


Cancellation Policy

We expect that there will be great demand to attend this conference. If you are unable to attend the conference, please contact Christine Van Luc at CASAT (contact information listed below), no later than Wednesday, April 28, 2009 so your reservation may be opened up for others to attend. Thank you.
For all issues, please contact Christine Van Luc at CASAT (dasa-support@casat.org) or call 775.784.6265 or toll free 877.922.6635
Please check that you have read and understand the cancellation policy.