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Region 3 CANPP Implementation Planning Sessions
Thank you for your interest in the implementation planning sessions! You will receive Zoom details and preparation information ahead of each session.
If you are registering for more than one person, please complete a separate form for each person.
If you have questions about the sessions or this form, please contact Mathew George at
mathew@advantageconsultingllc.com
.
For information on other regions' planning sessions, visit
https://abuse.publichealth.gsu.edu/canpp/
.
A map of all Georgia DFCS regions can be found at
https://dfcs.georgia.gov/locations/regional-map
.
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Email
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Your email
Prefix (if applicable; examples: Dr., Ms., Rev.)
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First Name
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Last Name
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Your answer
Suffix (if applicable; examples: Jr., PhD, RN)
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Preferred Name to Be Called
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County or counties represented in your participation (Check all counties where you live or work)
*
Bartow
Douglas
Floyd
Haralson
Paulding
Polk
I work at the state level (as opposed to serving these counties in particular)
Other:
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What is your role in the community? (Check all that apply)
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Parent/caregiver
Public/elected official
Business owner/leader
Civic leader
Community member, resident, neighbor, activist, friend
Service provider/professional
Academic
Other:
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If you are connected with any relevant organizations (such as working for a nonprofit service provider or holding a position in local government), please name the agency here:
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I plan to participate in these sessions:
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Because each session builds on the work in the previous session, we encourage you to participate in all sessions. If you must miss a session, please have a colleague or peer register to participate, as well, so that you can coordinate input and feedback.
Session 1: Friday 6/25, 9:30–11:30 a.m. (2 hours)
Session 2: Friday 7/16, 9–11:30 a.m. (2.5 hours)
Session 3: Friday 8/27, 9–11:30 a.m. (2.5 hours)
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