Building to Impact: Preventing Childhood Injury

Building to Impact: Preventing Childhood Injury
Friday, May 2^nd, 2014
Marbles Kids Museum, Raleigh

We hope you, or the best representative from your organization, will join us for this landmark event. Space is limited, so please reply at your earliest convenience to secure your seat.

RSVP required, due 4/15

Will you be attending?*

RSVP

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First Name*

Last Name*

Organization

Position Title

Please select which type of organization you represent:*

Public Safety Officials (e.g. Police; Fire; EMS) Government Non-Profit Academia/University Medical/Healthcare Facility Other (Please Specify)

Other

Email Address*

Phone Number

During the second part of our morning, we will have several opportunities to network and interact. To establish small groups in which this networking will occur, please complete the following three questions.

The networking groups begin at 10:45 a.m. Will you attend?*

Yes No

Please select two of the following injury causes in which you work or are interested in gaining more knowledge:

MVC Traffic-Occupant Assault (e.g. Child Abuse; Physical Violence; Sexual Violence) MVC Traffic-Pedestrian Self-Inflicted Falls

Please select two of the following areas of focus for your work:

Counseling Organizational Work/Education Advocacy Research/Data Program Evaluation Communication/Media Writing Rules or Policies Funding Other (Please Specify)

Other

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John Rex Endowment
832 Wake Forest Road, Raleigh, NC 27604
919.838.1110

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Building to Impact: Preventing Childhood Injury