LIFE IS SACRED Suicide Prevention/Life Promotion Training Application

Application Form

YSAC's Life is Sacred program is a 1.5 day suicide prevention/life promotion training program designed for front line workers/helpers to better understand some of the underlying reasons around suicide. This training program will help front line workers/helpers identify and build protective factors and resources around those they work with, and to better support and protect others in preventing suicide. This training program is also geared to build greater knowledge which significantly increases worker/helper confidence in the field of suicide prevention and life promotion.

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* 1. Who is requesting this training?

NNADAP/YSAC Treatment Centre

First Nation Community Based Detox/Stabilization Centre

First Nation Community/Organization

First Nation Child & Family Services

First Nation Post Secondary Educational Institution (Note: Facilitation and Travel costs may be applicable)

Non First Nation Organization (Note: Facilitation and Travel costs may be applicable)

Non First Nation Post Secondary Educational Institution (Note: Facilitation and Travel costs may be applicable)

Other (please specify)

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* 2. Name of Organization

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* 3. Contact Person requesting the Training:

Name

Address

Community/Town/City

Province

Postal Code

Email Address

Phone Number

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* 4. Preferred dates for the Training (require 2 consecutive days)

Date

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* 5. Location where the Training is to be held (Facility Name & Address)

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* 6. Approximately how many participants will be in attendance (recommend 25 maximum)

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* 7. Has there been any suicide attempts in your community within the last 3 months?

Yes

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* 8. Has there been any recent deaths by suicide in your community in the last 3 months?

Yes

If yes, this training is not suggested until community crisis response teams have provided initial support. Please share with us what crisis response support has been undertaken in the community since the death?

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* 9. As parts of this training could be triggering for some participants, it is important to have Mental Health and/or Cultural Supports available to provide support throughout the training. Please share which Mental Health and/or Cultural Support Person(s) will be available during the training (Name, Position)?

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* 10. In the spirit of partnership, collaboration and building community capacity, YSAC provides the training for free (with some exceptions). As the Host of this training, will you be able to provide the following in-kind services?

A training space for up to 25 people

Mental Health and/or Cultural Support personnel

Lunch and morning/afternoon refreshments on both days of training

Internet access for the Facilitator

Thank you for your interest in YSAC's Life is Sacred Suicide Prevention/Life Promotion Training. Once your Training Application is received, someone from YSAC will be in contact with you to confirm receipt of your application and begin the process of working with you to bring this important training to your organization, community, First Nation.