My Child Wants to Die - Online Registration

Thank you for your interest in the the free "My Child Wants to Die" webinar on Friday, September 14th at 12:00pm EST with Maureen Underwood, LCSW.

When completing the form below, please be sure to fill in all information that you are comfortable providing, and clicking "NEXT". Once you have reached a "THANK YOU" page, your registration will be complete.

If you have selected to watch this presentation live, you will receive an e-mail closer to the date of the webinar with access information. Those who attend the live taping of the webinar will also receive resources and a copy of the filmed version following the presentation.

Please know that there is a maximum capacity of 100 people who can be on the webinar live.  Please register for the live webinar only if you can tune in to the webinar on September 14th at noon.  

If you have selected to receive a filmed version of this webinar, you will receive this via e-mail one to two weeks following the taping of the live event.


Thank you!

SRF Suicide Prevention Research and Training Project
School of Social Work, Monmouth University

Dr. Michelle Scott, Program Director - mscott@monmouth.edu
Nicole D'Amore-Nolan, Program Specialist - ndamoren@monmouth.edu

Name:

Question Title

* 1. Name:

Town of Residence:

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* 2. Town of Residence:

Email:

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* 3. Email:

Ages/Gender of your Child(ren):

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* 4. Ages/Gender of your Child(ren):

Schools/School District:

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* 5. Schools/School District:

How would you like to participate in this webinar experience?

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* 6. How would you like to participate in this webinar experience?

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