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Mental Health Empowerment Project, Inc.

2006 Annual Conference

Pre-Registration Form

For November 2006 Conferences

Please choose one: New York City Region Conference, Friday, Nov. 3, 2006, New York, NY Western Region Conference, Wednesday, Nov.r 29, 2006, Rochester, NY

For groups only: Name of the group attending:
Please provide the first and last name (or last initial) of all attendees, separated by a comma:

For all: (If a group, provide the following information for the primary contact person.)
Name:
Address 1:
Address 2:
City:
State:
ZIP Code:
Phone:
Fax:
Email:

Mental Health Empowerment Project, Inc.
116 Everett Road, Suite 7
Albany, New York 12205

Phone: (518) 434-1393
Toll Free: 1-800-643-7462
Fax: (518) 434-3823

Email: mhepinc@aol.com

To register by phone, please call the above toll-free phone number.

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Mental Health Empowerment Project, Inc. 116 Everett Rd, Suite 7 Albany, NY 12205 Phone: 518-434-1393 or 1-800-MHEP-INC Fax: 518-434-3823 Email us © 2003 Mental Health Empowerment Project, Inc. All rights reserved. Site developed and maintained by Drum Communications