County of Los Angeles, Alcohol and Drug Program Administration

A Presentation by Dr. Darryl Inaba, Pharm.D. The Evolving Science of Relapse & Recovery Friday, February 5, 2010 Kyoto Grand Hotel & Gardens ~ 120 S. Los Angeles St., ~ Los Angeles, California Registration 8:30 am ~ Presentation 9 am – Noon EVENT REGISTRATION FORM This lecture is free but registration is required. Register online at WWW.AADAPINC.ORG or Clearly complete entire form below and fax to (323) 295-4075 (Attn: Jennifer) or Email to [email protected]

Please print clearly!!

______FIRST Name LAST Name

______AGENCY/ ORGANIZATION

______ADDRESS

______CITY STATE ZIP CODE

______PHONE FAX E-MAIL

Please specify the type(s) of Continuing Education (CE) credit you would like to receive:

C.A.D.C. (CAADAC, 2N-00-445-1109)

C.A.S. (BCAS/CAARR, 5033)

C.A.T.C. (CAADE, CP 20 809 C 0710)

MFT/LCSW (CA Board of Behavioral Sciences, PCE 2001)

OTHER ______

Certification/License Number ______

For more information, please contact Jennifer Kelchner at (323)293-6284.