QPR-July 21, 2016

9-11 am: QPR Training

The QPR Training will be held on July 21, 2016 from 9-11 am at Newton City Hall in Room 211. A light breakfast will be served.

This registration is for July 21st. If you want to register for another date visit www.newtonma.gov/newtoncares and click on the registration link for the date you want.

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* 1. Person attending training:

Name: *

Email Address:

Phone Number:

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* 2. I am a: (please choose all that apply)

Parent of a Newton Public Schools student

Parent of a private school student

Interested community member

Mental health professional

City of Newton Employee

Clergy or member of a Faith Based Organization

Andover Newton student/faculty/staff

Other (please specify)

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* 3. Please choose the category that best describes you:
(please note, this training date is intended for adults)

Age 18 to 29

Age 30 to 49

Age 50 to 69

Age 70 and older

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* 1. Person attending training:

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* 2. I am a: (please choose all that apply)

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* 3. Please choose the category that best describes you:(please note, this training date is intended for adults)

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* 4. If you are in need of a reasonable accommodation due to a disability, to attend this training, please indicate below.

* 3. Please choose the category that best describes you:
(please note, this training date is intended for adults)