Black Youth Mental Health Clinical Case Conference Series 
Event Timing:   6:00 pm - 8:15 pm ET In Person or Virtual

      Tuesday, January 16th   
      Wednesday, February 28th  
      Wednesday, March 13th   
      Wednesday, April 10th    
      Wednesday, May 8th    
      Wednesday, June 12th

Event Address:  Yale Child Study Center, 230 S Frontage Rd, New Haven, CT, 06520; Cohen Auditorium

Contact us at (475) 355-4146 or blackyouthccs@gmail.com
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Email *
First Name *
Last Name *
Affiliation/Organization *
Profession *
Will you attend the Tuesday January 16th conference?  NOTE: We are currently at capacity for in-person attendees (waiting list available).    *
I would like to be added to the in person waiting list (if no spots become available, you will automatically be placed on the virtual attendee list)
I will attend virtually
I will not be able to attend
Tuesday, January 16th
Will you attend the Wednesday February 28th conference?  NOTE: We are currently at capacity for in-person attendees (waiting list available) *
I would like to be added to the in person waiting list (if no spots become available, you will automatically be placed on the virtual attendee list)
I will attend virtually
I will not be able to attend
Wednesday, February 28th
Will you attend the Wednesday, March 13th conference?  NOTE: We are currently at capacity for in-person attendees (waiting list available)
*
I would like to be added to the in person waiting list (if no spots become available, you will automatically be placed on the virtual attendee list)
I will attend virtually
I will not be able to attend
Wednesday, March 13th
Will you attend the Wednesday, April 10th conference? NOTE: We are currently at capacity for in-person attendees (waiting list available) 
*
I would like to be added to the in person waiting list (if no spots become available, you will automatically be placed on the virtual attendee list)
I will attend virtually
I will not be able to attend
Wednesday, April 10th
Will you attend the Wednesday, May 8th conference?  NOTE: We are currently at capacity for in-person attendees (waiting list available)
*
I would like to be added to the in person waiting list (if no spots become available, you will automatically be placed on the virtual attendee list)
I will attend virtually
I will not be able to attend
Wednesday, May 8th
Will you attend the Wednesday, June 12th conference?  NOTE: We are currently at capacity for in-person attendees (waiting list available)
*
I would like to be added to the in person waiting list (if no spots become available, you will automatically be placed on the virtual attendee list)
I will attend virtually
I will not be able to attend
Wednesday, June 12th
Dietary restrictions? (i.e. gluten-free, kosher, vegetarian, vegan, food allergy, etc.) Please put "n/a" if attending virtually *
A copy of your responses will be emailed to the address you provided.
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