Advancing Behavioral Health SummitAdvancing Behavioral Health Wisconsin Logo

Tuesday, June 5, 2018
Kalahari Resort – 1305 Kalahari Drive, Wisconsin Dells, WI 53965

Registration Questions:

*required field

If you are experiencing problems registering, please contact Tim at (414) 955-5886 or Shari at (414) 955-4379 and they will be happy to assist you.

1.  First Name:* 

2.  Last Name:* 

3.  Email Address:* 

4.  Preferred Phone Number:*  (xxx-xxx-xxxx) 

5. Organization:* 

6.  Dietary Restrictions:* Yes No   If yes, Please describe:   
Note:  We will make every effort to work with the conference facilities to accommodate for dietary restriction.

7.  How did you hear about the Advancing Behavioral Health Summit?*  AHW e-Newsletter AHW Website
Word of Mouth Other   Please describe:  

8.  Do you have any printed materials/resources to place on a table for attendees to grab? (space is limited and will be offered on a first-come, first-serve, basis)  Yes No