Guardian Network Grey Bruce Training

Guardian Network Registration Form

Please complete the form below
DATE: February 22nd 2023

TIME: 9:00AM-5:00PM

LOCATION: GREY AGRICULTURE

SERVICES - 206 Toronto st. S

Markdale
Information collected in this registration form is for data collection purposes with the intent to identify best practices and improvements to the Guardian Network training and program. All information shared will remain confidential.
Full Name*

First NameLast Name
Occupation/Job Title
*

I am over the age of 18 (Guardians are required to be over the age of 18 to participate in the training and Guardian Network)
What region in Ontario do you currently reside? (Please selection one option that best applies)*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
E-mail*
example@example.com
The Guardian Network is a suicide prevention training and ongoing program within the Agricultural community. Please answer the questions below to reflect on your role as a Guardian:

How would you rate your current knowledge of suicide prevention? There is not right or wrong answer, the purpose of the training is to help you become more knowledgeable!

	Not knowledgeable at all	Somewhat knowledgeable	Neutral	Knowledgeable	Very knowledgeable

How would you rate your current knowledge on mental health? This can include the capacity to identify mental health problems, understanding of risk factors and causes, professional help available, attitudes that promote recognition, and appropriate mental health help-seeking behaviors.

	Not knowledgeable at all	Somewhat knowledgeable	Neutral	Knowledgeable	Very knowledgeable

Why do you want to be part of the Guardian Network?
How do you see your role as a Guardian in your community?
What are your needs and expectations as a Guardian?
Please include any concerns you have prior to the Guardian Network training. Please contact Bethany Parkinson (bparkinson@ontario.cmha.ca) for any urgent concerns or questions.
I agree that I am a participant in the Guardian Network and will abide by the rules, confidentiality, nonjudgment, risk taking, and respect for my own and others' limits as outlined by the group agreement during the training session
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Guardian Network Registration Form