Partners in Policy Training and Advocacy Day , 2020€¦ · Partners in Policy Training and...
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3405 W. Truman Blvd. #102, Jefferson City, MO 65109 1-800-374-2138 | 573-634-7727 Partners in Policy Training and Advocacy Day March 16-17, 2020 If you would like to get involved in advocating at the state level for policies that benefit those with mental illness, we invite you to attend our annual Partners-in-Policy Training and Advocacy Day events on March 16 - 17 in Jefferson City, MO. This free training is primarily geared toward those with mental illness, but there are a limited number of spots available for family members, friends and allies. Applications are due by by February 14, 2020. name phone email city , MO zip + 4 No Yes Please List: No Yes Name: Yes professional home address Do you have any special dietary needs? Would you prefer to room with someone? Will you need an accessible room? No Check all that apply: I am interested in: organizing or working with an advocacy group in my home area writing letters and/or calling legislators participating in advisory groups or councils Signature or Initials Date Mail, email or fax this application to Alice Kliethermes, Director of Consumer Services, NAMI Missouri, 3405 W. Truman Blvd. #102 Jefferson City, MO 65109 | Email: [email protected] | Fax: (573) 761-5636 |Ph: 573-634-7727 #203 Describe necessary accommodations below (optional): family member/ friend/ loved one/ ally of someone living with a mental illness Training materials, meals, lodging and transportation expenses are included and funded by NAMI Missouri with assistance of SAMHSA and other funding sources. The two-day session begins at 1:00 pm on Monday, March 16, 2020 at the Capitol Plaza Hotel in Jefferson City. For more information visit namimissouri.org/PartnersinPolicy. T-shirt size: S M L XL 2XL 3XL 4XL person living with mental illness I am a: meeting with legislators providing testimony in committee hearings unsure/ other Please answer the below questions in 1-2 sentences on another sheet of paper or the back of the application: 1. Why would you like to participate in this advocacy event? 2. Describe your experience with mental illness/ brain disorders. 3. Describe any past experience you have with advocacy or legislation. (No past experience is required.)
Transcript of Partners in Policy Training and Advocacy Day , 2020€¦ · Partners in Policy Training and...
3405 W. Truman Blvd. #102, Jefferson City, MO 65109 1-8 00-374-2138 | 573-634-7727
Partners in Policy Training and Advocacy Day
March 16-17, 2020If you would like to get involved in advocating at the state level for policies that benefit those with mental illness, we invite you to attend our annual Partners-in-Policy Training and Advocacy Day events on March 16 - 17 in Jefferson City, MO. This free training is primarily geared toward those with mental illness, but there are a limited number of spots available for family members, friends and allies. Applications are due by by February 14, 2020.
name phone email
city , MO zip + 4
No Yes Please List:
No Yes Name:
Yes
professional
home address
Do you have any special dietary needs?
Would you prefer to room with someone?
Will you need an accessible room? No
Check all that apply:
I am interested in:
organizing or working with an advocacy group in my home area
writing letters and/or calling legislators
participating in advisory groups or councils
Signature or Initials Date
Mail, email or fax this application to Alice Kliethermes, Director of Consumer Services, NAMI Missouri, 3405 W. Truman Blvd. #102 Jefferson City, MO 65109 | Email: [email protected] | Fax: (573) 761-5636 |Ph: 573-634-7727 #203
Describe necessary accommodations below (optional):
family member/ friend/ loved one/ ally of someone living with a mental illness
Training materials, meals, lodging and transportation expenses are included and funded by NAMI Missouri with assistance of SAMHSA and other funding sources. The two-day session begins at 1:00 pm on Monday, March 16, 2020 at the Capitol Plaza Hotel in Jefferson City. For more information visit namimissouri.org/PartnersinPolicy.
T-shirt size: S M L XL 2XL 3XL 4XL
person living with mental illnessI am a:
meeting with legislators
providing testimony in committee hearings
unsure/ other
Please answer the below questions in 1-2 sentences on another sheet of paper or the back of the application:
1. Why would you like to participate in this advocacy event? 2. Describe your experience with mental illness/ braindisorders. 3. Describe any past experience you have with advocacy or legislation. (No past experience is required.)
Please answer the below questions in 1-2 sentences each:
1. Why would you like to participate in this advocacy event?
2. Describe your experience with mental illness/ brain disorders.
3. Describe any past experience you have with advocacy or legislation. (No past experience is required.)
