Thank you for your interest in the Asynchronous PAX Good Behavior Game Online Training. 

Each participant must provide their own registration information and complete all 13 modules within 2 weeks in order to obtain credit for the course.

This project is supported by Texas Targeted Opioid Response, a public health initiative operated by the Texas Health and Human Services Commission through federal funding from the Substance Abuse and Mental Health Services Administration. Collection of specific demographic data among people served by this project informs our evaluation.

If you have any questions about this training you can email the Texas PAX Team at paxgbg@esc13.net.

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* 1. First Name

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* 2. Last Name

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* 3. Email Address (Please use all lowercase letters.)

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* 4. Position

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* 5. Please indicate your age group by choosing one of the following options

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* 6. What gender do you identify as?

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* 7. What race/ethnicity category do you identify most closely with? (Choose all that apply)

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* 8. School District (please use complete name)

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* 9. School Name

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* 10. School County

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* 11. ESC Region (Education Service Center)

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* 12. Is Your School Title 1?

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* 13. How many students do you serve?

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* 14. Which age groups do you teach? (Pick all that apply)

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* 15. Where do you want your training materials sent? (No P.O. Boxes please)

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