Northwest Regional Human Services Conference
 
 

Online Registration Form

Personal Information

Please enter your name and title as you wish them to appear on your name badge.

        This is my
State:


Conference Fees


Full Conference (which includes keynote speakers, reception, Lunch and a one year membership in the NWHS region)

OR  
Attendance to One Keynote Speaker

Please indicate Speaker:

OR  
Attendance to Both Keynote Speakers
OR  
Contemporary Ethics in Community Mental Health Scott Rasmussen, LCSW and Barbara Crumrine, LCPC
AND/OR  
Friday Speaker and Luncheon
   


Scholarship for Full Time Students (please complete):

We have a limited amount of student scholarships available that will cover conference registration fees (not travel or lodging). Students who would like to apply for a scholarship need to initially pay their conference fees and complete the form below. You will be contacted by the Conference Committee regarding whether or not your scholarship was approved. If your scholarship is approved, your conference fees will be reimbursed upon check in at the conference.