Location:  NAMI Fox Valley Office
211 E. Franklin St
Appleton, WI

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* 1. Participant Contact Information

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* 2. For which NAMI Affiliate will you be taking this training?

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* 3. To take this NAMI Wisconsin training you need approval from your affiliate, please list the person from your affiliate that invited you to participate in this training?  

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* 4. Mental Health Chat is a training targeting elementary students grades 3 - 5 to discuss mental health and reduce the stigma of seeking help.  Are you a consumer, family member, or friend of someone who identifies as living with a mental illness?

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* 5. This training will be from 9:30 am - 3:00 pm. Lunch and all materials will be provided as part of the training but transportation to and from the training, any hotel needed and all other meals will be the responsibility of participants or their affiliate.   Please type your initials to acknowledge this information.

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* 6. Should we be aware of any physical accommodations for you to participate in this training?

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* 7. NAMI Wisconsin will send you a confirmation email 6 weeks to a month prior to the training with more detailed information.  This email will include some pre-reading and video you must review prior to the training.  Thank you for your interest in reducing the stigma of Mental Health needs in your community elementary schools!

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* 8. Please share your t-shirt size.  For example Ladies large, or Men's small.  Thank you.

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