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Register for 2021's all virtual Recovery Advocacy Day!
Join the Washington Recovery Alliance (WRA) and members of the mental health and substance use recovery community for RECOVERY ADVOCACY DAY 2021, on Thursday, February 11!
Registration is *required* for this event. Once you complete this form, the WRA will arrange meetings with your lawmakers on your behalf. Make sure to enter your E-mail to stay informed, as updates will be coming soon!
QUESTIONS? Please contact our Program & Operations Manager, Theresa, at
theresa@warecoveryalliance.org
.
Name
*
First Name
Last Name
Pronouns
select one
He/Him/His
She/Her/Hers
They/Them/Theirs
Other
Prefer not to say
Email
*
Phone Number
Residential Address
*
Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Legislative District
If you know it, put it here! If not, no worries! Leave it blank and we'll find it for you!
Mailing Address (if different!)
Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Organization/Employer
Have you attended RAD before?
select one
Yes, more than once before
Yes, once before
No, this is my first Recovery Advocacy Day!
What is your connection to recovery?
Please select any/all that apply:
I am in recovery from substance use challenges
I am in recovery from mental health challenges
I love someone who has been impacted by substance use challenges
I love someone who has been impacted by mental health challenges
I work in the behavioral health field
I'm a concerned community member
Other (please describe below)
If "other", how would you describe your connection to recovery?
Would you be willing to testify in support of recovery legislation at a hearing (most likely virtual) in Olympia?
select one
Yes
No
Please let us know if there are any accommodations you need to be able to attend and enjoy RAD 2021:
Interpretation, accessibility needs, etc.
WRA Staff may be taking screenshots of virtual activities/meetings to share in the future on social media, in email communications, and on our website. Is it alright to include you in these pictures?
*
Yes
No
I heard about RAD through...
select one
Friend
Family member
Coworker
WRA social media (Facebook, Instagram, Twitter)
WRA email
Regional coalition social media
Regional coalition email
Other
If "other", please describe how you heard about this event:
Is there anything else we should know?
Would you like to be added to the WRA's mailing list?
Yes
No
