School-Based Prevention Services Request

School Year 2025-26

Question Title

1. Today's Date (Required.)

Please specify.

Date

Question Title

2. Contact Information (Required.)

Name

Title

School District (if applicable)

Name of School (or Organization)

Email Address

Phone Number

Trainings & Technical Assistance for Staff

Question Title

3. Please select which of the following Trainings Services you are requesting for your staff (check all that apply)

Presentations on Alcohol and Other Drugs (AOD)

Be Sensitive, Be Brave (BSBB) Suicide Prevention (Virtual, Self-paced)

Be Sensitive, Be Brave (BSBB) Mental Health Training (Virtual, Self-paced)

Promoting Protective Factors within School Communities- Technical assistance and Training

Postvention/Grief Support

Crisis Response Team - Consultations and Technical Assistance

None of the Above

Trainings & Programs for Youth

Question Title

4. Please select which of the following Trainings & Programs you are requesting for your youth (check all that apply)

Botvin Lifeskills Training for Elementary Students

Botvin Lifeskills Training for Middle School Students

Botvin Lifeskills Training for High School Students

Presentations on Alcohol and Other Drugs (AOD)

Be Sensitive, Be Brave (BSBB) Suicide Prevention Training (High School)

Be Sensitive, Be Brave (BSBB) Mental Health Training (High School)

Safe Messaging Training for youth

Friday Night Live for Elementary Students

Friday Night Live for Middle School Students

Friday Night Live for High School Students

None of the Above

Trainings & Supports for Caregivers/Parents

Question Title

5. Please select which of the following Trainings & Supports you are requesting for your caregivers/parents (check all that apply)

Presentations on Alcohol and Other Drugs (AOD)

Panel discussion: Promoting Mental Health and Preventing Substance Use in Teens

Be Sensitive, Be Brave (BSBB) Suicide Prevention Training

Be Sensitive, Be Brave (BSBB) Mental Health Training

Postvention/Grief Support

None of the Above

Resources Request

Question Title

6. If applicable, please indicate which of the following topic areas you would like to receive resource materials for (check all that apply):

Alcohol and Other Drugs

Mental Health/Suicide Prevention

Not Applicable

Other (please specify)

Question Title

* 1. Today's Date (Required.)

Question Title

* 2. Contact Information (Required.)

Question Title

* 3. Please select which of the following Trainings Services you are requesting for your staff (check all that apply)

Question Title

* 4. Please select which of the following Trainings & Programs you are requesting for your youth (check all that apply)

Question Title

* 5. Please select which of the following Trainings & Supports you are requesting for your caregivers/parents (check all that apply)

Question Title

* 6. If applicable, please indicate which of the following topic areas you would like to receive resource materials for (check all that apply):

1. Today's Date (Required.)

2. Contact Information (Required.)

3. Please select which of the following Trainings Services you are requesting for your staff (check all that apply)

4. Please select which of the following Trainings & Programs you are requesting for your youth (check all that apply)

5. Please select which of the following Trainings & Supports you are requesting for your caregivers/parents (check all that apply)

6. If applicable, please indicate which of the following topic areas you would like to receive resource materials for (check all that apply):