Event Registration

Please complete the form to register for this event.

Whether you’re a jurist, attorney, AAG, DHHS supervisor/caseworker, CPS specialist, Infant Mental Health clinician, or want to know more about the ECC docket, this training is tailored to meet your needs and enhance your understanding of serving infants, toddlers, and their families in child welfare. Together, let’s deepen our understanding and strengthen our collective impact on the lives of our youngest citizens.

Event: * Please select:

Select the event you are registering for - you may attend more than one! Just complete a separate registration for each event.

Attendance: *

Yes, I plan on attending the entire time.

No, I can only attend for a portion of the event.

If you are unable to attend the full time, please let us know what dates/times you will be attending in the “Comments/Special Requests” field below.

Your Contact Information

First Name: *

Last Name: *

Job Title: *

Email: *

Please use your work email (i.e. agency email) and not a personal email (i.e. Gmail, Yahoo, etc.).

Phone: *

Agency Information

Agency: *

ECC Court Team: * Please select: No, I am looking to develop a ECC court team Yes, I am a part of an ECC court team

Agency’s Mailing Address: *

City: *

State: * Please select: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

ZIP: *

Additional Information

Comments/Special Requests:

Optional: please let us know if you have any special requests or dietary restrictions.

Register