YMHFA Registration- 5/12/18 FFC Registration Question Title * 1. Address Name Company Address City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Phone Number Question Title * 2. Please selection your occupation Teacher Transportation Staff Para-Professional or Para-Educator School Administrator Athletic Coaches and Physical Education Staff School Health Services School Health Professional School Behavioral Staff School Support Staff Juvenile Justice or Corrections First Responders (Police, Firefighters, Emergency Health) Spiritual or Religious Leader Other Other (please specify) Question Title * 3. Please enter a valid email address for registration confirmation: Question Title * 4. If someone I know needed help for mental or emotional health, I would feel confident responding appropriately. Strongly Disagree Disagree Neutral Agree Strongly Agree Question Title * 5. I know how to recognize the signs of someone potentially experiencing a mental health challenge or crisis. Strongly Disagree Disagree Neutral Agree Strongly Agree Question Title * 6. I know how to assess and respond to someone having a mental health challenge or crisis. Strongly Disagree Disagree Neutral Agree Strongly Agree Done