Registration For:

NOT ON MY WATCH! Combating the Opioid Epidemic and Overdose Deaths Educational Hands-On Rescue Training for Faith, Community, and School-based Stakeholders

First Name

Last Name

Title

Organization

Email

Phone

I have knowledge of:

The Opioid/Heroin Overdose Epidemic

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Opioid-type Substances

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The Naloxone/Narcan Opioid Antidote

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Overdose Rescue Amnesty-Good Samaritan Laws in GA

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Person/s who had an Overdose from Opioid Misuse

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I would like to attend (choose one training only):

March 16, 2016: The Temple, 1589 Peachtree St NE, Atlanta GA 30309 Time (1:30PM – 3:30PM) or March 17, 2016: Milton Center, 86 School Drive, Alpharetta GA 30004 Time (12Noon – 2PM)

March 16, 2016

March 17, 2016

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