First name: *

Last name: *

Organization (if applicable):

Phone: *

Email: *

Address: *

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Box Lunch Provided. Let us know if you need a:

Vegetarian lunch Gluten-free lunch

Cost:

R&R House staff (no charge)

Register on or before October 30 for $125 and after October 30 for $145.

Payment method:

Pay with credit card

Pay with check - make your check payable to MHA and mail to:
MHA, Attention: R&R Motivational Interviewing, 600 W. Virginia St., Suite 502, Milwaukee WI 53204

Registrant Details:

Cost:

Payment method: