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Brief Alcohol Screening and Intervention of College Students (BASICS) Training Registration

Please fill out the registration form below to attend our FREE BASCIS Training.
If you wish to receive Social Work or Mental Health Counseling CEUs please contact Kathleen Coletta at kcoletta@yesccc.org or 516-799-3203 x127 for payment. Fee for 10 CEU Credits: $100.00.

Tuesday, January 10, 2023 from 9:00 am – 3:30 pm
Wednesday, January 11, 2023 from 9:00 am – 3:30 pm
1.Name:(Required.)
2.Email:(Required.)
3.What agency, school or any other entity are you affiliated with:(Required.)
4.Job Title:(Required.)
5.Department:(Required.)
6.Do you need a FREE CASAC/CPP certificate? (Required.)
7.Would you like Social Work (SW) or Mental Health Counseling (MHC) CEUs for attending this training? (Required.)
8.If you answered yes to the above question, please provide the type of CEU credit needed and contact Kathleen Coletta at kcoletta@yesccc.org or 516-799-3203 X127
9.Please provide license number for CEU credit:
Current Progress,
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