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* 1. Will you be attending the Workshop on Saturday, May 10th?

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* 2. Will you be attending the Continental Breakfast at 8:30 a.m.?

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* 3. Enter your Name, Title and/or Organization?

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* 4. What is your Position? (i.e., Teacher, Parent, Social Worker)

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* 5. Enter your Address, City, State and Zip:

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* 6. Email Address:

**PLEASE BRING YOUR STATE ID# FOR ACT48 CREDITS.

**NASW PA CHAPTER CEU CREDITS FOR SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS, AND PROFESSIONAL COUNSELORS WILL BE AVAILABLE FOR PARTICIPANTS TO PROCESS.

We look forward to seeing you at the Greater Deliverance Church, 800 South First Avenue, Coatesville, PA.

T