Teen QPR Suicide Prevention Training (15 years +) November 9, 2021

Parents and Guardians Register Your Youth Here!

Description: 1-hour training for youth (15 years +) to learn how to recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone to help.

This is a one-hour online training that will take place on the Cisco WebEx meeting application. You can download WebEx on your mobile phone or visit the WebEx online website. You can attend through phone, app, or WebEx website. **Further information will be emailed to you as the training date nears (please check your email).

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* 1. Please enter all your correct contact information. (complete all fields).

First & Last Name *

Mailing Address

City/Town

State/Province

ZIP/Postal Code

Email Address *

Phone Number *

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* 2. District

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* 3. Please select which QPR training date for youth you will attend

Tuesday November 9, 2021 at 6:00 p.m. - 7:00 p.m.

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* 4. *Emergency Contact (all participants are required to list an Emergency Contact to promote safety & support. Questions? Contact Latonya Yazzie at 520-610-2394

Emergency Contact Name

Emergency Contact Phone Number

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* 5. I,_________________________, the parent/guardian grant permission for this suicide prevention training. I have provided my contact information below for BHS Prevention Program to contact me by phone call for verification of permission.

Name of Parent/Guardian

Email Address

Phone Number