12.6.24 Adult Allies for LGBTQ+ Youth BIP

Thank you for registering for Mental Health First Aid for Adult Allies of LGBTQ+ Youth!

Please fill in all fields and hit submit at the bottom.
First Name*
Last Name*
Email*
Hidden Email*
example@example.com
Have you ever signed up for an MHFA in the past, created a profile in "Connect" Learning Management System but had to cancel? (We ask because it will likely cause an issue with enrolling you in another class.)

Yes, I have registered for a different MHFA class in the past two years and think I have an existing account in Connect.No, I don't think so. I haven't signed up for another MHFA class before today.Other
We are sorry for the inconvenience, but because we won't be able to enroll you in this class with the same email address, will you please provide an alternative email address for us to use in Connect? Thank you!
Thank you for your help with this issue. National Council is attempting to fix this problem.
Email*
example@example.com
Organization*
N/A if not applicable
Title/Position*
N/A if not applicable
Phone*
That you can be reached during class
County of Residence*
Please specify what accommodation(s) you need, if any
If no accommodations needed, please leave blank
I am available to attend my MHFA training course on...*

(Please add date, time and format)
** I am available to attend the in-person portion of my MHFA training course on...*

Friday, December 6 9:30 am-3:30 pm
Training Logistics for In-Person Classes:

Location: Campbell County Public Library-Newport Branch

Address: 901 East 6th Street, Newport, KY 41071

Parking: Park in lot

Other: Lunch will be 30 minutes. Either bring your own or plan to grab something and bring it back with you.
Confirmation of Pre-Work: Your blended class includes a required 2-hour pre-work assignment that must be completed prior to the start of the live training. The pre-work is self-paced, and you will receive directions on how to complete this approximately two weeks prior to your training date via a calendar invitation for the class.*

I commit to complete my pre-work prior to my blended class.
Cancellation Policy: Should you need to cancel, please give as much notice as possible. No-shows on the day of training may result in a charge as your spot has been reserved at a $170/value. Funding is limited, so a cancelled class means fewer people can receive this special training at no cost to them.*

I commit to clearing my calendar for the entire class time.
{firstName}, you are one step closer to becoming one of 3 million Americans who are certified in Mental Health First Aid (MHFA), an evidence-based course that will teach you how to identify, understand and respond to signs of mental illnesses and substance use disorders in real, actionable ways.

You will:

·       Grow in your knowledge of signs, symptoms and risk factors

·       Identify multiple types of professional and self-help resources

·       Increase your confidence in and likelihood to help an individual in distress

·       Show increased mental wellness yourself

·       Help reduce negative attitudes and perceptions

Next Steps:
1. After you submit this form, you will receive your first informational email confirming your registration and giving you an opportunity to learn more about MHFA.
2. Approximately 2 weeks prior to the start of your training you will receive a calendar invitation with all your class details and an introduction to your instructors.
3. The week of your training your instructors will send emails confirming the class details and preparing you for the day-of logistics for your training.
4. You will also get emails from National Council's system so be prepared for a lot of reminders!
Thank you again for registering to take Mental Health First Aid!
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Thank you for registering for Mental Health First Aid for Adult Allies of LGBTQ+ Youth!