Family Education Workshop Registration

Please include the information below to register for our Family Education Workshop.

Due to space limitations, priority is given to families and patients currently being seen in the U-M Depression Center. All adolescent and adult family members are welcome to attend.

You may also register by calling Susan Wonnacott at 734-764-0250.

Fields marked with required are required.


First Name:

Requiredrequired

Last Name:

Requiredrequired

Number of attendees:

RequiredInvalid format.The entered value is less than the minimum required.The entered value is greater than the maximum allowed.required

Name(s):
Please list any additional attendees/family members in spaces provided.






Mailing Address:

Phone:

E-Mail:

Requiredrequired

Which workshop date would you like to attend?

July 2014 – no wrkshp
Wednesday, Aug 6, 2014
Sept 2014 – no wrkshp
Wednesday, Oct 1, 2014
Wednesday, Nov 5, 2014
Wednesday, Dec 3, 2014
Please make a selection

Please check one:

I am a person with depression
I am a family member of a person with depression

What is your relationship to the family member (e.g. husband)

Where did you hear about this event?

What would you like to learn at this workshop?

        

Thank you for registering for an upcoming Family Education Workshop offered by the University of Michigan Depression Center.