2023 Indiana Council Fall Conference Registration

This is a BYONB (Bring Your Own Name Badge) Event. The Indiana Council will not have name badges on-site. Please bring your name badge associated with your CMHC/company

Name *

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Center/Organization *

Address *

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Zip Code

Additional Attendee(s)

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Committee Meetings: Wednesday, October 4, 3:00 - 5:00 PM

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Addictions, Adult Services & Employment Services Committee: Names of attendees

Please list members who are attending the meeting, separated by commas.

Chief Financial Officer Committee: Names of attendees

Please list members who are attending the meeting, separated by commas.

Child and Adolescent Committee: Names of attendees

Please list members who are attending the meeting, separated by commas.

Data Analytics Committee: Names of attendees

Please list members who are attending the meeting, separated by commas.

Thursday Evening Reception: Names of attendees *

Please list members who are attending the meeting, separated by commas.

Human Resources Committee: Names of attendees

Please list members who are attending the meeting, separated by commas.

Quality Improvement (QI) Committee: Names of attendees

Please list members who are attending the meeting, separated by commas.

Racial Equity and Leadership Committee: Names of attendees

Please list members who are attending the meeting, separated by commas.

CCBHC/Mobile Crisis: Names of attendees

Please list members who are attending the meeting, separated by commas.

Friday Business Meeting: Names of attendees *

Please list members who are attending the meeting, separated by commas.

Fee Level: *

Member: Early Bird - $200.00
Member: w/in 7 Days - $210.00
Partner: Early Bird - $210.00
Partner: w/in 7 Days - $220.00

If you are not a Partner or CMHC Member, please contact Lee Ann Jordan, Director of Communications and Marketing, ljordan@indianacouncil.org, to learn about our membership opportunities.

Disclaimer:
Please note we cannot issue a refund for cancellations that are received within 72-hours of the start of the conference.