School Health Assistant Training

1. Select Your Training Date
Training Schedule
Please indicate if you have any special needs to actively engage in this training:

Sign languageClosed captioningAdvanced access to materials

2. Provide Your Contact Information
Attendance Status

AttendedNo ShowCancelled
E-mail (that you check often)*
First Name*
Last Name*
School Name*
Use the dropdown menu to select your school district*
Use the dropdown menu to select your Charter School District *
Please specify other*
Address*

Street Address

Street Address Line 2

City

Zip Code
Phone Number*

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Do we have permission to text you if we are unable to reach you via email?

YesNo
Nurse Supervisor *

First NameLast Name
Nurse Supervisor Email *

3. Tell Us More About You
Which work assignment best describes your position? *

Health OfficeCare for Special Needs
Please indicate the grade level of students you service as health assistant.*

Pre-SchoolElementary SchoolMiddle SchoolHigh School
How many months/years have you been employed as a school health assistant? *

4. Agree to Terms & Conditions
By registering for this event, I acknowledge and agree:*

To participate in the training in full; no partial attendance.It is my responsibility to submit my certificate to the NM Public Education Department for my license.To be in a fixed location with Wi-Fi, a computer, camera, and microphone with an appropriate background free of distractions.To complete the required evaluations.To turn my camera on during Q&A discussions, and actively participate.To contact the training office as soon as possible if I need to cancel my participation.That the organizer reserves the right to remove me from the Virtual Event if, in its sole discretion, determines that my participation or behavior creates a disruption or hinders the Virtual Event or the enjoyment of the Virtual Event content by other attendees.
Email Validator*
Signature
Should be Empty:

FY22-23 Registration Form