Mental Health First Aid 2010 Training Site Survey

Question Title

Please enter your contact information.

Name: *

Company: *

Address: *

Address 2:

City/Town: *

State: *

ZIP/Postal Code: *

Email Address: *

Phone Number: *

Question Title

How many people from your organization are you likely to apply to send to a Mental Health First Aid 5-day instructor training and certification program in 2010?

Question Title

Which of the locations below are you most likely to apply for? Note: Trainings with dates are already scheduled. Other locations will be scheduled based on interest and demand.

Orlando, FL March 10-14

Blue Bell, PA (outside of Philadelphia) May 3-7

Washington, DC June 28-July 2

Houston, TX July 12-16

Los Angeles, CA September 13-17

Albuquerque, NM

Atlanta, GA

Boston, MA

Chicago, IL

Dallas, TX

Miami, FL

San Francisco, CA

I do not plan to apply for/attend any course at any of the above

Other (please specify)

Question Title

When would be the most convenient time of year for you to attend a five-day training?

No particular time is better than another

Specific month & year (please enter below)

Question Title

Are you willing to host an instructor training in your area (provide venue, AV, catering, etc. and help recruit participants in return for a limited number of free registrations)?

Yes

Maybe

Question Title

Please enter your contact information.

Question Title

How many people from your organization are you likely to apply to send to a Mental Health First Aid 5-day instructor training and certification program in 2010?

Question Title

Which of the locations below are you most likely to apply for? Note: Trainings with dates are already scheduled. Other locations will be scheduled based on interest and demand.

Question Title

When would be the most convenient time of year for you to attend a five-day training?

Question Title

Are you willing to host an instructor training in your area (provide venue, AV, catering, etc. and help recruit participants in return for a limited number of free registrations)?

Question Title

Let us know of any comments/questions you may have about Mental Health First Aid. Learn more at www.MentalHealthFirstAid.org