2020 ITI Guest Registration

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SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
MINORITY FELLOWSHIP PROGRAM
American Nurses Association
2020 Intensive Training Institute
Theme: The Intersectionality of Trauma, Racism, and Social Determinants of Behavioral Health across the Life Span: Implications for Prevention Strategies, Practice, Research and Policy
March 18-22, 2020 
Hyatt Regency Waikiki Beach Resort & Spa

GUEST REGISTRATION FORM

Please complete this guest registration form and submit to the Office of the MFP by February 20, 2020 to confirm your participation in the Intensive Training Institute, March 18-22, 2020, at the Hyatt Regency Waikiki Beach Resort & Spa, in Honolulu, HI.  

A reservation at the MFP group rate of $209/night plus taxes will be made on your behalf; however, you are responsible for payment of your lodging. A reservation confirmation number will be emailed to you from the Office of the MFP shortly after the February 20 cut-off.

NAME
ADDRESS
CONTACT
EMERGENCY CONTACT
Please Check All Dates of Attendance/Activities:
Wednesday, March 18, 2020
Thursday, March 19, 2020
Friday, March 20, 2020
Saturday, March 21, 2020
Sunday, March 22, 2020