2023 Employee Registration - Western Partnerships Conference on Human Services

Name*

First Last

Title*

Program*

Use drop down to select your program.

Program

If your program is not listed in the dropdown box, please list it below

My Supervisor*

Email Address*

Conference Registration*

Thursday Aug. 10th (One day only)- $20
Friday Aug. 11th (One day only) – $20
Two Day Registration – $25
I am NOT attending conference

Banquet Registration*

Banquet is FREE for RISE Idaho employees

No, I am NOT attending banquet
Yes, I am attending banquet and I am a RISE ID Res & Day Programs Employee
Yes, I am attending and I am a RISE Pediatric Therapies employee
Yes, I am attending and I am a RISE Family Services Employee

Banquet Guests RISE ID Res & Day Programs*

I am NOT bringing guests
1 Guest $0.00
2 Guests $30.00
3 Guests $60.00

Banquet Guests RISE Pediatric Therapies*

I am NOT bringing guests
1 Guest $30.00
2 Guests $60.00
3 Guests $90.00

Banquet Guests RISE Family Services*

I am NOT bringing guests
1 Guest $30.00
2 Guests $60.00
3 Guests $90.00

Banquet Meal Choice*

Please select your entrée

Grilled Portobello Mushroom: Lemon-Leek Polenta, Ratatouille, and Butternut Squash Puree (Gluten-Free, Vegan, Dairy-Free)
Pan-Seared Salmon: Parmesan Risotto Cake and Roasted Red Pepper Lemon Cream (Gluten-Free)
Braised Boneless Beef Short Ribs: Twelve-Hour Braised, Boneless Beef Short Ribs, Mashed Idaho Potatoes, Braising Jus, and Roasted Root Vegetables (Gluten-Free)

Banquet Meal Choice Guest 1*

Grilled Portobello Mushroom: Lemon-Leek Polenta, Ratatouille, and Butternut Squash Puree (Gluten-Free, Vegan, Dairy-Free)
Pan-Seared Salmon: Parmesan Risotto Cake and Roasted Red Pepper Lemon Cream (Gluten-Free)
Braised Boneless Beef Short Ribs: Twelve-Hour Braised, Boneless Beef Short Ribs, Mashed Idaho Potatoes, Braising Jus, and Roasted Root Vegetables (Gluten-Free)

Banquet Meal Choice Guest 2*

Grilled Portobello Mushroom: Lemon-Leek Polenta, Ratatouille, and Butternut Squash Puree (Gluten-Free, Vegan, Dairy-Free)
Pan-Seared Salmon: Parmesan Risotto Cake and Roasted Red Pepper Lemon Cream (Gluten-Free)
Braised Boneless Beef Short Ribs: Twelve-Hour Braised, Boneless Beef Short Ribs, Mashed Idaho Potatoes, Braising Jus, and Roasted Root Vegetables (Gluten-Free)

Banquet Meal Choice Guest 3*

Grilled Portobello Mushroom: Lemon-Leek Polenta, Ratatouille, and Butternut Squash Puree (Gluten-Free, Vegan, Dairy-Free)
Pan-Seared Salmon: Parmesan Risotto Cake and Roasted Red Pepper Lemon Cream (Gluten-Free)
Braised Boneless Beef Short Ribs: Twelve-Hour Braised, Boneless Beef Short Ribs, Mashed Idaho Potatoes, Braising Jus, and Roasted Root Vegetables (Gluten-Free)

Professional CEU's

If you require CEU’s, please make a selection from the following options: Association of Social Workers (NASW) or Behavior Analysist Certification Board (BACB) You will NOT receive CEU’s if you do not register for them.

NASW
BACB
I do NOT require CEU credits

BACB Certification Number*

If you require BACB CEU’s, please provide your BACB Certification Number.

Thursday Opening Keynote*

Will you be attending the opening keynote presentation by Josh Shipp?

Yes, attending Thursday opening keynote
Not attending Thursday opening keynote

Session 1 – Thursday Aug. 10 – 10:45am-12:15pm*

Choose the session you will be attending

Steps to Independent Living – Sarah Gornik and Melissa Vian
African Orphanages and Human Trafficking: Some Parallel Lessons to Supporting People with Disabilities in America – Gerald Nebeker
Behavioral Momentum: From Resistance to Reinforcement – Andy Crossman
Say What? The Ethics and Impact of Language in Human Services – Sarah Andrade
Suicide Prevention Fundamentals Instruction – Ali Shields
Not Attending

Session 2- Thursday Aug. 10th – 1:45pm-3:15pm*

Choose the session you will be attending

An Integrative Experience – Applying Polyvagal Theory into Practice Part 1- Lex Fanopoulos and Roger Evenson
Functional Uses of Music in the Therapy World – Samantha Foote
Supporting Self-Determination in Persons with Disabilities – Diane Bigler
Change the Conversation with Charting the Life Course Framework – Sara Lloyd and Rosemary Ellis
Peer Leadership: Establishing a Culture of Authenticity – Chris Garcia
Not Attending

Session 3 Thursday Aug. 10th- 3:30pm- 5:00pm*

Choose the session you will be attending

An Integrative Experience – Applying Polyvagal Theory into Practice Part 2 – Lex Fanopoulos and Roger Evenson
Self Management: Get YOU out of Your Client’s Intervention – Andy Crossman
Understanding the IEP: Reading the Actual Document – Sarah Gornik and Melissa Vian
Apprenticeship: A Pathway to a Career – MiKayla Monaghan and Caleb Tibbitts
Just Keep Swimming: How to stop the negativity and build positive momentum – Kirsten Walker
Not attending

Friday Opening Keynote*

Will you be attending the opening keynote presentation by Russell Lehmann

Yes, attending Friday opening keynote
Not attending Friday opening keynote

Session 1- Friday, Aug. 11th – 10:30am-12:00pm*

Choose the session you will be attending

The Emotional Epidemic of Childhood Conditioning Part 1 – Natalie James
Confidently Supporting a Client in Crisis – Elizabeth Caval-Williams
Leading Better Lives with Person Centered Thinking Tools – Hayley Helm and Sarah Allen
The Competing Behavior Pathway: A Tool for Creating Strategic and Effective Behavior Intervention Plans – Audrey Kennedy
It’s Not Just About Work – Increasing Awareness of Employee Wellness – Kirsten Walker
Not attending

Friday Commitment to Community Luncheon*

Will you be attending the Commitment to Community luncheon? (price is included in your conference ticket)

Yes, I’m attending the luncheon
No, I am not attending the luncheon

C2C Luncheon Meal Choice*

Grilled Chicken Pasta Primavera: Grilled Breast of Chicken, Fresh Vegetables, Fettuccine Noodles, and House-Made Alfredo
Grilled Choice Center Cut Top Sirloin Steak: Balsamic-Molasses Marinade, Rosemary and Garlic-Roasted Fingerling Potatoes, and Caramelized Shallot-Portobello Mushroom Demi-Glace (Gluten-Free)
Eggplant Rotini: Black beans, Potatoes, Sweet Peppers, Roasted Tomato Sauce, and Fried Leeks (Gluten-Free, Vegan, Dairy-Free)

Special Meal Requirements

Please indicate any special meal requirements, such as gluten free, vegetarian/vegan. The conference will try to accommodate meal requests, but does not guarantee all requests can be met.

Session 2- Friday, Aug. 11th- 1:30pm-3:00pm*

Choose the session you will be attending

The Emotional Epidemic of Childhood Conditioning Part 2- Natalie James
From Compliance to Compassion: How to Use Today’s ABA – Audrey Kennedy
Supporting Parents with Learning Difficulties – Cathy Haarstad
IdahoGamerGirl Presents: Level Up Your Role – Gina Johnson
The Power of Positivity and Healing Effects of Sound – Julie Walker
Not attending

Total Due

$0.00

Payment*

I would like to pay by

Credit Card
Check. Mail payment to RISE, Inc. 3040 N Five Mile Road, Boise ID 83713. Memo Line should include attendee name and WPCHSChecks must be received by 8/4/23.