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MHFA Class Request Form - Community Partners

ACCESS VT MHFA Grant-Funded Class Request Form

Thank you for your interest in a grant-funded ACCESS VT Mental Health First Aid training.

Please complete this interest form, and we will respond shortly.

Filling out this form is not a guarantee that we can fund and/or provide this training. We will get back to you as soon as possible with a response.

1.Please provide your name, email, best telephone number and organization.
2.What type of MHFA class are you requesting?
3.Please identify the proposed date (s). Best practice is 4-6 weeks in the future.
4.What organization (s) will be participating in this training?
5.Are you looking for in-person or virtual?
6.How many participants are expected at this training? The course requires a min of 10 and a max of 30.
7.What county will this class be held in?

If you are requesting a virtual course, please select the most appropriate county for where your training is located based on where the majority of your work takes place, choosing Statewide for participants from around the State of Vermont.
8.Please provide any additional information relevant to your class request here.