PRC Training Needs Assessment Survey FY2015

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1. Date (Required.)

Date:

Date

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2. Please provide the following information: (Required.)

Name: *

Organization: *

Address:

Address 2:

City/Town:

ZIP:

County:

Email Address: *

Phone Number:

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3. In what areas would you like to receive training? (select all that apply) (Required.)

Bullying

Self Harm/Cutting

Suicide Prevention

Suicide Postvention

Drug Trends

Tobacco Trends and Use

Eating Disorders

Internet Safety

Strategies for Strengthening Families

Risk and Protective Factors/ Resiliency

Mental Health Topics

Child/Adolescent Development

Ethics for Prevention Professionals

Ethics(LCDC, LPC, Social Work, LMFT)

HIV/HEP C

Crisis Intervention

Child Abuse/Neglect

Counseling Strategies

Community Mobilization

Strategic Prevention Framework

Post Traumatic Stress Disorder

COPSD

Cultural Awareness

Classroom Management

School Safety

Continuing Education for Prevention Providers/Advanced Prevention Training (DSHS)

Prevention Staff Training (Initial 15-hour training) (DSHS)

Other (please specify)

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4. Are you interested in substance abuse curriculum training? (Required.)

Yes

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5. If so, which one(s)

Kids' Connection (Curriculum Based Support Group)

Youth Connection (Curriculum Based Support Group)

Too Good for Drugs

All Stars

Project Towards No Drug Abuse

Project Success

Creating Lasting Family Connections

LifeSkills Training

Positive Action

Strengthening Families Program

Reconnecting Youth

Other (please specify)

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6. How many training hours are you required to get a year for your certification?

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7. How far are you willing to travel to attend a training? (Required.)

0 - 30 miles

30 - 60 miles

60 - 90 miles

100 or more miles

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8. What kind of CEU's do you need?

Social Work

LMFT

Certified Prevention Specialist

CCJP

TCLEOSE

LPC

LCDC

Other (please specify)

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* 1. Date (Required.)

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* 2. Please provide the following information: (Required.)

Question Title

* 3. In what areas would you like to receive training? (select all that apply) (Required.)

Question Title

* 4. Are you interested in substance abuse curriculum training? (Required.)

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* 5. If so, which one(s)

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* 6. How many training hours are you required to get a year for your certification?

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* 7. How far are you willing to travel to attend a training? (Required.)

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* 8. What kind of CEU's do you need?

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* 9. Please provide any recommendations you have for topics and/or presenters for future trainings.

1. Date (Required.)

2. Please provide the following information: (Required.)

3. In what areas would you like to receive training? (select all that apply) (Required.)

4. Are you interested in substance abuse curriculum training? (Required.)

5. If so, which one(s)

6. How many training hours are you required to get a year for your certification?

7. How far are you willing to travel to attend a training? (Required.)

8. What kind of CEU's do you need?

9. Please provide any recommendations you have for topics and/or presenters for future trainings.