PATH Workshop Registration Form

If the workshop is canceled or rescheduled, please send a notice including the starting date of the workshop, the course ID, and the workshop leaders' names to info@mihealthyprograms.org.

Questions? Write to info@mihealthyprograms.org.


To register a PATH Workshop with Michigan Partners on the PATH, complete the form below and click Submit.

After submitting your registration, you will receive a confirmation message within five business days with course ID and location ID.


Type of Workshop
Start Date
End Date
Time of Workshop

Workshop Location
Location Name
Address 1
Address 2
City
Zip
County
Location Type
Please specify if "other"
Workshop Fee
CLOSED WORKSHOP
 Not open to public

Licensed Agency
(REQUIRED)
Select one. Only agencies with a Stanford License are listed.

Partner Agency (Not all workshops will have a Partner Agency)
Works directly under or with the Licensed Agency, i.e. AAA or CMH office
Funding Source
2nd Funding Source

Workshop Leader Information
Leader #1
   
Leader #2
   

Contact Person (for public listings)
Name
Phone
Email

Registration Submitted By
(for registration questions from MDHHS)
Name
Phone
Email

Other Information
Workshop Language
(if other than English)
"Other" Notes
(Examples-Special population or location, dates not consecutive, etc.)

Will there be a Session 0 (zero) for this workshop?




Session "0" is an optional pre-workshop demonstration/information session.

Veterans Administration Workshops
 Check here if the workshop is held at a VA facility and/or primarily for participants who are veterans.

Community Mental Health Workshops
 Check here if the workshop is primarily for participants with serious mental illness.
 Check here if the workshop will be led by at least one Certified Peer Support Specialist.

Community Health Workers
 Check here if the workshop will be led by at least one Community Health Worker.

If you would like a copy of the Registration Form for your records,
Print before clicking the Submit button.