Skip to content
2022 - 2023 - Ernie Mendes Trainings
For more information about these trainings and future trainings, please visit: https://first5siskiyou.org/
If you have any questions related to registration, please call First 5 Siskiyou at
(530) 918-7222
*
1.
Please Select all trainings that you wish to attend:
(Required.)
Tuesday, May 23, 2023 - Reducing Compassion Fatigue and Burnout - Part 3 - Ernie Mendes - 2:45 to 5:00 p.m.
*
2.
Participants Information
(Required.)
Full Legal Name (First/Middle/Last)
*
Address
City/ Town
*
State
*
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
*
County of Residence
*
Phone Number
*
*
3.
Email
(Required.)
Please enter your email
Please confirm your email
*
4.
Would you like to receive, by e-mail, information about future trainings, activities, and events relating to parenting and professional development in Siskiyou county?
(Required.)
Yes
Already on the list
No, thank you
*
5.
Primary Language
(Required.)
English
Spanish
Other (please specify)
6.
Secondary Language
English
Spanish
Other (please specify)
*
7.
Please Check All That Describe You:
(Required.)
Adoptive parent with child under age 18
In the process of adoption of children under age 18
Birth Parent with children under age 18
Foster Parent
Informal Relative/ Kinship Care Provider/ Non-Related Extended Family Member (ie. grandparents raising grandchildren)
Provider of child care as needed for family, friend, or neighbor
State-funded preschool provider
Early Head Start/Head Start Center Based
Early Head Start or Other Home Visitation Programs
Other child care center provider
Community Member interested in the topic
Social Services Professional
County Probation Staff
Foster Family Agency Staff
Short Term Residential Therapeutic Program Staff (Previously Group Home)
Family Resource Center Staff/Volunteer/Board Member
Health Care Professional/ Administration
Teacher/Staff - Preschool
K-12+ administrator, teacher, staff
College Faculty/Administration/Staff
Law Enforcement
Tribal Program Staff
Student
County Board of Supervisor/City Council/Special District Member
County/City Administration
CASA Volunteer
Behavioral/Mental Health
County Board of Supervisor or City Council or Special District
Family or community advisory board
Community or Family Resource Center Board member, staff, or volunteer
Other Non-Profit
Other (please specify)
*
8.
Are you interested in being a Resource Family? (Foster Parent)
(Required.)
Yes
No
Possibly, would like more information
*
9.
Would you like a Certificate emailed to you to show your completion of participation in this training?
(Required.)
Yes
No
