Registration Form
Fill out the form carefully for registration. The East Bay Regional Coalition is providing mental health awareness trainings through funding provided by SAMHSA. Participants who receive free training will be better able to offer resources to people in need. This program is run through an MHAT grant.
Name
*
First Name
Middle Initial
Last Name
E-mail
*
example@example.com
Mobile Number
Choose the training you would like to attend:
Aging Vibrantly Adults January 16th, 10:00 am at the East Providence Senior Center
Aging Vibrantly Adults January 29th, 10:30 am at the Barrington Senior Center
Submit Application
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