QPR Training Interest Form QPR Training Inquiry Form Thanks for your interest in holding a QPR (Question, Persuade, Refer) Suicide Prevention Training! Please take a moment to fill out the QPR Training Inquiry Form. OK Question Title * 1. Name OK Question Title * 2. Telephone OK Question Title * 3. Email OK Question Title * 4. Date or dates of specific training request. (The more specific, the more helpful for our cadre of trainers.) OK Question Title * 5. Time of Training (is applicable) OK Question Title * 6. Business/School/Civic Organization/Church/Group Name (if applicable) OK Question Title * 7. Number of Anticipated Audience Members OK Question Title * 8. Training Location (if applicable) (e.g. Faith Church, XXX Street, XXXX City) OK Question Title * 9. Type of Audio/Technology Available at your desired location listed above Screen Laptop Wi-Fi Projector Speakers None of the Above Other (please specify) OK Question Title * 10. Comments OK Thanks for your interest in having a QPR (Question, Persuade, Refer) Suicide Prevention Training! Please allow for 10 business days (or sooner) to receive a response as we reach out to the HSC 2020 cadre of certified QPR trainers. Thank you for being a mental health champion! If you have questions or do not hear back during 10 business days, please call MHA Sheboygan at (920) 458-3951 or email firstname.lastname@example.org. OK ALL DONE!