Mississippi Minority Mental Health Symposium Attendee Registration
December 3-4, 2026- Courtyard Marriott - Beach Blvd. |Gulfport, MS.
Registration Information:
Please complete the information below to register for the Mississippi Minority Mental Health Symposium. Attendees seeking continuing education credit should provide accurate professional and licensure information. Lunch is NOT included in registration. CE certificates will be issued on based on a verified attendance and completion of all applicable symposium CE requirements. Attendees are responsible for providing accurate licensure information. Attendees must be present for the entire session to receive CEU credit.
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Registration Type:
Please Select
General Registration (Both Days w/CEU's)
General Registration (Both Days non-CEU's)
General Registration (Thursday only)
General Registration (Friday only- half day)
Student Registration (non- CEU)
Community Conversation (Thursday evening)
Professional Information
Social Worker
Counselor
Therapist/Clinician
Psychologist
Nurse/Nurse Practitioner
Educator/School Professional
Community/Non Profit Professional
Student
Clergy/Public Official
Other
Are you requesting education credit?
Yes
No
Continuing Education Information (CEU's)
NBCC
MS Board of Examiners for SW'ers
I am not requesting a CE
Professional License/Credential Type
License/Credential Number
State of Licensure
Name as it appears on your professional license
Symposium Attendance
Thursday
Friday
Both Days
I plan to attend the Community Conversation (Thursday Evening)
Do you require accessibility?
Yes
No
How do you hear about the MS Minority Mental Health Symposium
Email
Previous Attendee
Social Media
Colleague/Friend
Community Organization
Employer/Agency
Other
My Products
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Symposium Registration (Both Days- CEU's)
$150.00
$
150.00
Symposium Registration (Thursday only-CEU's)
$100.00
$
100.00
Symposium Registration (Friday only-CEU's)
$50.00
$
50.00
Symposium Registration (Non CEU)
$45.00
$
45.00
Student Registration
Must be a current college student.
$40.00
$
40.00
Community Conversation
Evening reception open to the community. Limited seats available.
Free
$
Free
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Submit Registration
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