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For an Application/Information Packet

If you would like to receive an application/info packet about upcoming training opportunities through the Certificate Program in Psychiatric Vocational Rehabilitation, please fill out the following information request form and click the Send Form button when finished.

Completion of the form below will allow you to download a pdf application packet. If you would prefer an application packet sent by postal mail, please indicate in the form below.

Information Request Form

*denotes required field

*First Name:
*Last Name:

Agency/Organization

*Street Address:

*City:
*State:
*Zip:

Agency Type:

Position:


Country:

Phone Number (please include area code):

*Email address (ex: debbien@bu.edu):

How did you find out about the Certificate Program in Psychiatric Vocational Rehabilitation?
Flyer/brochure
Search Engine (i.e. yahoo, google)
Employer/colleague
Word of mouth
Other

Completion of this form will allow you to download an electronic application packet.

I would like a response to a specific question (below)
I would like to receive the Mental Health & Rehabilitation eCast once a month with special announcements from the Center for Psychiatric Rehabilitation.

Comments/Questions:

You may direct all questions regarding the Certificate Program in Psychiatric Vocational Rehabilitation to debbien@bu.edu.

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Contact Us | © Center for Psychiatric Rehabilitation, Trustees of Boston University| Updated June 15, 2009