Mental Health First Aid

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* 1. Please select the date of the Mental Health First Aid training you wish to attend:

Friday, September 11, 2020 (Youth Mental Health First Aid only) 9:00 a.m. - 2:00 p.m. (BLENDED LEARNING training; requires 2-hour self-paced course PRIOR to virtual training on 9/11/2020. Participants will receive an email with link to virtual content approximately one week prior to the virtual event.)

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* 2. Your First Name:

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* 3. Your Last Name:

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* 4. Your Email Address:

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* 5. Best Daytime Telephone Number to Reach You:

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* 6. Agency or Affiliation:

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* 7. How did you learn about this training opportunity?

Website

Social Media (Facebook, Twitter, etc.)

Community Coalition

Local newspaper

Word of mouth

Other

Mental Health First Aid

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* 1. Please select the date of the Mental Health First Aid training you wish to attend:

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* 2. Your First Name:

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* 3. Your Last Name:

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* 4. Your Email Address:

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* 5. Best Daytime Telephone Number to Reach You:

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* 6. Agency or Affiliation:

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* 7. How did you learn about this training opportunity?

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* 8. If you selected "Other" for the question above, please provide specifics: