Thank you for your interest in the PREVENT Facilitator Toolkit. The toolkit is intended for PREVENT graduates to use when conducting educational sessions on the primary prevention of violence in their communities or within their own organizations.

If you would like to receive the toolkit, please fill in the information below.
In addition, as a recipient of the toolkit, we ask that you agree to the following conditions for use of the toolkit by indicating below.

1. I understand that by ordering this toolkit, I agree to make the proper attribution to the PREVENT program at the University of North Carolina Injury Prevention Research Center.

I understand that by ordering this toolkit, I agree to make the proper attribution to the PREVENT program at the University of North Carolina Injury Prevention Research Center. I agree

2. I agree to provide feedback on my experience with the toolkit to PREVENT as part of its quality improvement efforts.

I agree to provide feedback on my experience with the toolkit to PREVENT as part of its quality improvement efforts. Yes

3. Which PREVENT training did you attend?

Which PREVENT training did you attend? 2005 Regional Workshops

2005 Institute

2006 Institute

CMT Institute

2007 Institute

Other (please specify)

4. Please fill in all fields.

Please fill in all fields. Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

5. What is the best method for contacting you?

What is the best method for contacting you?