CTS Ldr Train_Sept2015.pub - COAW—Consortium for Older Adult

Cancer: Thriving and Surviving
Leader Training
Cancer: Thriving and Surviving
Leader Training
This is an evidence-based program from Stanford University
and trains leaders to facilitate the Cancer: Thriving and Surviving class for cancer survivors. Community classes are facilitated by two trained leaders and the topics covered include:
1) techniques to deal with problems such as frustration, fatigue,
pain, isolation, poor sleep and living with uncertainty, 2) appropriate exercise for regaining and maintaining flexibility,
and endurance, 3) making decisions about treatment and complementary therapies, 4) communicating effectively with family,
friends, and health professionals, 5) nutrition, 6) setting priorities, and 7) relationships.
Successful participants of this 4-day Leader Training will: illustrate following the Leader Manual content and process; recognize how to handle problem people appropriately; use positive
reinforcement techniques with group members; apply strategies
to encourage group participation and use effective modeling
strategies, and do two practice teaching activities. The class
includes a Leader Manual, a reference book and CD. Successful participants will receive a certificate and may co-offer this
class in the community, under the licensure of the Consortium
for Older Adult Wellness.
CEU transcripts are available 2 weeks after the completion of
the training. Contact Pam Allen, [email protected] or 303-9841845 to request your transcript.
As an IACET Authorized Provider, COAW
offers CEUs for its programs that qualify under
the ANSI/IACET Standard.
September 10-13, 2015
8:30am - 4:30pm
Lakewood Link Recreation Center
1295 S Reed St.
Lakewood, CO 80226
$650 per person
50% discount for 2nd person from same
organization.
Snacks and lunch provided daily.
3 Ways to REGISTER:
1. Online at www.coaw.org
2. Fax pg. 2 of this form to 303-984-5962
3. Mail to: COAW
2575 S. Wadsworth Blvd.
Lakewood, CO 80227
For more information:
Pam Allen
[email protected]
303-984-1845
1-888-900-2629
For more information:
Pam Allen
[email protected]
303-984-1845
1-888-900-2629
Cancer: Thriving Surviving
Leader Training
September 10 - 13, 2015; $650
Lakewood, CO
3 Ways to REGISTER:
1. Online at www.coaw.org
2. Fax form to 303-984-5962
3. Mail to: COAW
2575 S. Wadsworth Blvd.
Lakewood, CO 80227
REGISTRATION INFORMATION
Name ________________________________________________________________
Home Address _________________________________________________________
st re et / cit y /
st at e
/
zip
Employer/Organization ____________________________________________________
Work Address _________________________________________________________
st re et / cit y /
st at e
/
zip
Home Phone _______________________ Work Phone __________________________
CANCELLATION
POLICY:
Cancel by July 30, 2016
to receive a refund minus
$25 administrative fee.
The administrative fee is
$50 is cancellation is
between July 31 and
Aug. 13, 2016.
After Aug. 13, 2016, no
refund.
Cell Phone _________________________ Fax ________________________________
Email _____________________________ Birthday ____________________________
Emergency Contact Name/Phone _____________________________________________
PAYMENT
Registration Fee: $650
Cash/Check Enclosed
Visa
Mastercard
Discover
Please Invoice
Card Number ________________________________________
Exp. Date _______________________
CID Code ___ __ ___
Name on Card _______________________________________
Card Billing Address ___________________________________
Vegetarian Meals
Requested.
Card Billing Zip _______________________________________
Signature ____________________________________________
Gluten-free Meals
Requested.
Check here if you have a condition or need which may require an accommodation. Please describe
here:
______________________________________________________________________________________________
PRESS RELEASE WAIVER - I authorize, allow and release to COAW the unlimited publication, broadcast, transmission, re-transmission
and/or other form of reproduction of any and all audio, video and photographic images without payment of compensation or
royalties. COAW will not sell or provide any information or images to any other agency or organization. Your waiver is given by
completing this form and registering for the Academy for Older Adult Wellness UNLESS you inform COAW otherwise in writing.