“The Many Faces of Addiction ” - Fond Du Lac Tribal and Community ...

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MONDAY – July 29, 2013 9:00 a.m. – 12:00 p.m. Special Session: Ethics 12:00 p.m. – 5:00 p.m. Registration 12:00 p.m. – 1:00 p.m. Opening Ceremony - Lunch provided 1:00 p.m. – 3:00 p.m. Keynote Speaker - Jeff Linkenbach, EdD 3:00 p.m. – 3:15 p.m. Afternoon break 3:15 p.m. – 5:00 p.m. Keynote Speaker - Jeff Linkenbach, EdD 5:00 p.m. – 6:30 p.m. Community Feast 6:30 p.m. – 7:30 p.m. General Session - Jeff Linkenbach, EdD 7:30 p.m. – 9:00 p.m. Evening activity - Karaoke and Talent Show TUESDAY – July 30, 2013 7:45 a.m. – 9:15 a.m. Breakfast and Registration 8:00 a.m. – 9:00 a.m. Ojibwe and Lakota Language and Culture Classes 9:00 a.m. – 10:15 a.m. Keynote Speaker - Karina Forrest-Perkins 10:15 a.m. - 10:30 a.m. Morning Break 10:30 a.m. - 12:00 p.m. Keynote Speaker - Karina Forrest-Perkins 12:00 p.m. – 1:00 p.m. Lunch 1:00 p.m. – 2:30 p.m. Break out sessions 2:30 p.m. – 2:45 p.m. Afternoon break 2:45 p.m. – 4:00 p.m. Break out sessions 4:00 p.m. – 5:30 p.m. Talking Circle, Al-Anon, or Cultural Art Class 5:30 p.m. – 9:00 p.m. Supper/Narrated Vista Cruise WEDNESDAY – July 31, 2013 7:45 a.m. – 9:15 a.m. Breakfast and Registration 8:00 a.m. – 9:00 a.m. Ojibwe and Lakota Language and Culture Classes 9:00 a.m. – 10:30 a.m. Keynote Speaker - Kathleen Tavenner Mitchell 10:30 a.m. – 10:45 a.m. Morning Break 10:45 a.m. – 12:00 p.m. Keynote Speaker - Kathleen Tavenner Mitchell 12:00 p.m. – 1:00 p.m. Lunch 1:00 p.m. – 2:30 p.m. Break out sessions 2:30 p.m. – 2:45 p.m. Afternoon break 2:45 p.m. – 4:00 p.m. Break out sessions 4:00 p.m. – 4:30 p.m. Closing Ceremonies for Prevention Conference 4:30 p.m. – 6:00 p.m. Special Session: Ethics 4:30 p.m. – 5:30 p.m. AA Meeting, Talking Circle or Cultural Art Class 5:30 p.m. – 6:30 p.m. Supper 6:30 p.m. – 9:00 p.m. Evening activity - Movie Night THURSDAY – August 1, 2013 7:45 a.m. – 9:15 a.m. Breakfast and Registration 8:00 a.m. – 9:00 a.m. Ojibwe and Lakota Language and Culture Classes 9:00 a.m. – 10:30 a.m. Keynote Speaker - Robin Poor Bear 10:30 a.m. – 10:45 a.m. Morning Break 10:45 a.m. – 12:00 p.m. Keynote Speaker - Robin Poor Bear 12:00 p.m. – 1:00 p.m. Lunch 1:00 p.m. – 2:30 p.m. Break out sessions 2:30 p.m. – 2:45 p.m. Afternoon break 2:45 p.m. – 4:00 p.m. Break out sessions 4:00 p.m. – 5:30 p.m. Special Session: Ethics 4:00 p.m. – 5:30 p.m. AA Meeting, Talking Circle, or Cultural Art Class 5:30 p.m. – 6:30 p.m. Supper 7:00 p.m. – 9:00 p.m. Evening activities - Outdoor Concert FRIDAY – August 2, 2013 7:45 a.m. – 9:15 a.m. Breakfast and Registration 8:00 a.m. – 9:00 a.m. Ojibwe and Lakota Language and Culture Classes 9:00 a.m. – 10:30 a.m. Keynote Speaker - Craig M. Nakken 10:30 a.m. – 10:45 a.m. Morning Break 10:45 a.m. – 12:00 p.m. Keynote Speaker - Craig M. Nakken 12:00 p.m. – 1:00 p.m. Lunch 1:00 p.m. – 3:00 p.m. Keynote Speaker - Craig M. Nakken 3:00 p.m. – 3:30 p.m. Closing Ceremony 4
MN American Indian Institute on Alcohol and Drug Studies Registration Form Have you taken a course at FDLTCC in the past? □ Yes □ No Name ________________________________________________________________________________ Home address _________________________________________________________________________ City __________________________________________ State __________ Zip ____________________ Personal Phone ____________________ Birthdate _________ Personal Email _____________________ Employer _____________________________________________________________________________ Title/Position __________________________________________________________________________ Employer address _______________________________________________________________________ City __________________________________________ State __________ Zip ____________________ Work phone ______________________________ Work email __________________________________ Ethnic Background (optional, check one): ___ African American ___ American Indian/Alaska Native ___ Asian/Pacific Island ___ Caucasian ___ Hispanic/Latino Other (please specify) ________________________________ American Indian/Alaska Native Students (This section is to be completed only by individuals who are enrolled or affiliated members of a federally recognized American Indian Tribe.) I hereby authorize my Tribal Enrollment Department to release a tribal blood certificate to Fond du Lac Tribal & Community College for the purpose of college enrollment only. I understand the information is confidential and Fond du Lac Tribal & Community College will use it only for the stated purpose. Applicant’s full name _______________________________________________ Birth date _________________________ Reservation & Band name ______________________________________________________________________________ Father’s name _____________________________________________________ Birth date _________________________ Reservation & Band name ______________________________________________________________________________ Mother’s name ____________________________________________________ Birth date __________________________ Reservation & Band name ______________________________________________________________________________ Applicant’s signature _______________________________________________ Date ______________________________ Has your tribal enrollment been previously verified by FDLTCC? □ Yes □ No Certification of Tribal Enrollment (This section to be completed by tribal records office personnel only. Please return to FDLTCC- Records Office, 2101 14 th Street, Cloquet, MN 55720.) I certify that __________________________________________________________________________________________________ is an (check one) □ Enrolled □ 1 st descendent □ 2 nd descendent □ not enrolled of the ________________________________________________________________________________________________________________ Tribe. Enrollment No. _________________________________________________ Blood Degree _______________________________________________ □ Eligible for BIE Services □ Ineligible for BIE Services Turn over to continue… Important information to know about completing this registration form: The continuing education course you are registering for is supported wholly or in part by Fond du Lac Tribal & Community College. We ask that you assist us in documenting your participation by completing this registration form, thereby ensuring future continuing education opportunities. It is important that this registration form include your current address, and date of birth. This identifying information is currently the only way the Minnesota State Colleges and Universities record system recognizes registration in any event sponsored by Fond du Lac Tribal & Community College. Agency Name ____________________________________________________________________________________________________________ Agency Address ____________________________________________________________________________________________________________ Certifying Official’s Signature_________________________________________________________________________________________________ 5
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