Michigan Association for Infant Mental Health
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Michigan Association for Infant Mental Health
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Event Registration
ECLS.2021.9.13.IMH Leadership Day
ECLS.2021.9.13.IMH Leadership Day
13 available
Name
*
First
Last
Email (you will receive a confirmation email using this entry)
*
Agency/Organization
*
Cell Phone (emergencies only)
*
Are you a Licensed Social Worker or Licensed Professional Counselor?
*
Yes
No
License Number (required for continuing education)
*
What is your level of endorsement, if applicable?
*
Infant Family Associate
Waiver
Infant Family Specialist
Infant Mental Health Specialist
Infant Mental Health Mentor
Not Applicable
Please indicate your discipline
*
BA
BS
BSN
BSW
EdD
LP
LPC
MA
MEd
MS
MSW
MSN
PsyD
PhD
How many years have you been supervising IMH clinicians?
*
Under a Year
1-5 years
6-10 years
11-15 years
16-20 years
21 years +
How many people do you supervise in an IMH setting?
*
1-5
6-10
11-15
16-20
21 +
What are you hoping to gain from this training?
What questions do you have for the trainer? These will be given to the trainer before the training day.
ECLS.2021.9.13.IMH Leadership Day quantity
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