NACCM Media Club: Who is in Charge Anyway? An Exploration of Personal Empowerment and the film, “I Care A Lot” Registration Name: * Required First Last Company: * RequiredMailing Address: * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone: * RequiredPrimary Contact Email for Registrant: * Required List your Degrees, Licenses, and/or Certifications: * Required(enter N/A if not applicable)How many year of experience do you have in care management? * Required(enter N/A if not applicable)I would like a CMC CE Certificate: * RequiredYesNoI would like a NASW CE Certificate: * RequiredYesNo($25 fee for CE Certificate)Social Work License #: * RequiredHow did you hear about us? * RequiredSelect OneNACCM NewsletterSocial MediaALCA/Other newsletterColleagueAuthorOtherN/AHow did you hear about us? Other * RequiredRegistration Options: * RequiredSelect OneNon-CMCCMC (enter coupon for $20 credit)CMC Coupon Code: * Required ($20 discount)TOTAL: $0.00 Once you press "Pay Now", you will be redirected to Paypal.com. You must complete your payment before your registration is received and processed.You will receive email notifications with event details and instructions prior to the event.