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November 2023 Youth Mental Health First Aid Training (IN-PERSON)
This IN-PERSON training will take place on November 15th from 9:00 a.m. to 5 p.m.
*
1.
Participant Information
(Required.)
Name
ZIP/Postal Code
Email Address
Phone Number
*
2.
Which category best represents your organization and interest in Youth Mental Health First Aid?
(Required.)
Government
Law Enforcement
Civic/Volunteer
Education
Child Welfare
Court Services/Juvenile Justice
Youth-serving non-profit
Adult-serving non-profit
Business
Parent/Caregiver
Community Member
Faith Community
Healthcare
Media
City Board/Commission
Other (please specify)
3.
Organization and job title (if applicable)
*
4.
Please type your name in the box below to acknowledge the following statements: I understand that I will receive an email invitation from MHFA Connect (please check your spam folder) after the training. I understand that I must complete the evaluation form online and print my certificate.
(Required.)
The following three questions are optional. This information is collected to ensure Youth Mental Health First Aid trainings reach all populations in Alexandria.
5.
What is your race?
Asian or Pacific Islander
Black or African American
Hispanic or Latino
White or Caucasian
Multiracial or Biracial
Other (please specify)
6.
What is your gender?
Male
Female
Transgender
Nonbinary
Other (please specify)
7.
What is your age?
18-20
21-24
25-44
45-64
65+
