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Serving Survivors with Disabilities (WEB)

Friday, May 21, 2021
10:30 pm - 12:00 pm

Virtual

MCEDSV non-members are welcome and invited to attend.

CEUs for Social Work must be requested and paid in advance (fee: $25.00/person)

Registration Fee

$0 - Individual

$25 - Individual with CEUs/Social Work

CEUs for Social Work (skip this field if you don't need them). If you are requesting CEUs, enter your licensure number here.

MCEDSV is an approved provider of CEUs for Social Work only. MCEDSV can only issue a CEU certificate if you provide your licensure # here, participate fully and follow complete sign-in instructions onsite at the event.

Step One
Your Registration Information

Name *

First Name

Last Name

Name prefix or suffix? i.e. professional credentials or degrees earned; for example: JD, LMSW, and PhD.

This includes professional credentials or degrees earned; for example: JD, LMSW, and PhD.

Do you go by a nickname? (This will be printed on your name tag and all event lists and reports).

Your contact information & other stuff we need to know :)

Your Email: *

Thank you for double-checking accurate entry. If your email address is entered with typos, unfortunately, you will miss important event-related details and messaging from us :(

Verify Email *

Your Position/Title: *

Full Organization/Agency Name *

Thank you for providing the full organization name, (and acronyms are ok too). Please do not abbreviate or enter an incomplete organization name.

Organization/Agency Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Do you have accessibility support needs or requests? Please share...

Serving Survivors with Disabilities (WEB)

Step One
Your Registration Information

Your contact information & other stuff we need to know :)

Almost done!

To ensure your registration goes through, click "Submit" below.

Serving Survivors with Disabilities (WEB)

Step OneYour Registration Information

Your contact information & other stuff we need to know :)

Almost done!

To ensure your registration goes through, click "Submit" below.

Step One
Your Registration Information