2015 VETERANS / SaVE ActRETREAT REGISTRATION FORM
Northen New Mexico CollegeEXITOCounseling Office, Veterans Resource Center
the Student Veterans Association present:
PART I: “RESILIENCY TRAINING: RELIEF, RELEASE, & CONTROL PTSD - DON’T LET IT CONTROL YOU”
For anyone who has been through a traumatic experience
October 16 17, 2015
Northern New Mexico College, Española
Featuring Keynote Speaker, TeacherNeuroscientiest, Dr. Layne Kalbfleisch
For more information, or to REGISTER, contact:
Ana X Gutiérrez Sisneros,EXITO Mental Health Counselor, VE 103-A, 747-2256, email or Frank Orona, in theVeterans Resource Center (VRC), AD265-B, 747-5499
Name: ______Address: ______
City/ Zip: ______Phone: ______Email: ______
(The VRC offering a scholarship to all VETERANS for a double room, for Friday night only)
NNMC
Veteran Student______
Banner ID:______
Veteran Dependent____ / Rooms:
______double ______differently abled access / free*
Community Members
Veteran ___
Veteran Dependent___
Our host hotel is the
Ohkay Casino Resort Hotel / Rooms:
______double _____ differently abled access / free*
Community Members, Other
Non –Veteran (room charge) / Rooms:
______double _____ differently abled access / $ 52.99*
*Meals that are included are: two lunches, one breakfast, one dinner, and all breaks
____ ADA accommodations: we will contact Ohkay Owingeh for any special needs you might have, in advance of the event.
Address: 68 NM-291, Ohkay Owingeh, NM 87566 Phone: (505) 747-1668
Check here for the following needs: ____Vegetarian dinner, breakfast or lunch _____ Vegan dinner, breakfast, or lunch____Gluten free
****Early registration ends October 9, 2015****
Your registration will be confirmed via email or phone (if you do not have an email). Max: 50
Cancellations: Registered attendees must request a refund in writing 2 weeks prior to the conference. Refunds will be mailed, by check, after conference.
About Our Presenter
Dr. Layne Kalbfleisch
“Relief and release are two natural resources your body has at its disposal if you have the right tools and
mindset. PTSD makes you feel far away from what is actually available within yourself. This workshop will
teach you some tools and mindsets to help you re-connect to parts of the change process that can help you heal
and bounce back. Learn how to befriend stress, turn anxiety and uncertainty to your benefit, and see beyond circumstance” (L. Kalbfleisch, personal communication, March 5, 2015).
Layne Kalbfleisch, educational psychologist and neuroscientist, studies the relationship between talent and
disability and how the human brain supports ingenuity and problem solving across life. She has been featured
on CNN with Dr. Sanjay Gupta, SiriusXM Doctor Radio, The Coffee Klatch – Special Needs Radio, and the
Rhode Island PBS show, ‘School Talk’.
Keynote Speech, May 2015:
'The New Story of Water' - Blue Mind 5, Carnegie Institute of Science, Washington, D.C.:
Interview on Musical Training to Neuroscience: TDLC Science Network, UC, San Diego:
AXGS: axgs, 9-16-2015