Connor's Climb Foundation (CCF) is dedicated to preventing youth suicide by educating teens about the warning signs of mental illness or emotional distress.  As a result of generous donations, CCF is able to provide the SOS Signs of Suicide prevention programs for Middle and High Schools to the community at no charge. 

As a recipient of this sponsored program, you agree to the following:

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1. I WILL:
  • Identify a key staff person(s) to lead this project at our school.
  • Implement the SOS program with at least one grade level within one year of receiving it.
  • Complete the program evaluation form within 30 days of receipt.  (Data collected does not reflect student information; rather, it provides quantitative data regarding student demographics and numbers/percentages of students seeking help as well as qualitative feedback for SMH on program successes and challenges.)
 (Required.)

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2. First Name

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3. Last Name

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4. Email Address

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5. Phone

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6. Title/Role

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7. School/Organization

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8. School Address

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9. SOS Program(s) to be implemented:

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10. Expected SOS Implementation Date:

Date

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11. Approximate number of students who will receive the program:

T