Mental Health First Aid Individual Registration

*Asterisk indicates a required field.

Name *
Name
What do you do?
Where do you work?
What are your credentials?
Would you be interested in participating in a short online 3 and 6-month follow-up survey? *
Do you need CEU credits? Available for the following professions: LSW, LCSW, CPC, LCPC, LMFT *
How did you hear about this training? (select all that apply) *
Why are you interested in this training? *
Boxed lunch will be provided only for a full one-day, 8-hour training. Please indicate any dietary restrictions (select all that apply) *
I have read the information below and agree to uphold the identified expectations to the best of my ability. *
I agree to Terms and Conditions *