REGISTER: FACILITATOR CERTIFICATION TRAINING

Facilitator Training Registration

For Professionals and Paraprofessionals working with Home Visitation Programs, Group, Individual, and/or Family Settings (visits in person or virtual).
ATTEND TRAINING WITH
Nurturing Families Center
Dr. Sonya M. Thorn MSOL, LCSW
CEO/National Trainer/Author/Consultant

Contact: Nurturing Families Center, 830-743-9955 or sonya@nurturingfamiliescenter.com

Registration Includes: 18 hours of training: 12 hours of Professional Continuing Education Units and 6 hours of Trauma-Informed Continuing Education Units, the Facilitator Manual and Family Workbook.

Location: ZOOM video conferencing
Please note that registered attendees are expected to understand and utilize ZOOM video conferencing, screen sharing, and Microsoft Powerpoint. Registering yourself or your staff for the training below provides acknowledgment of this requirement.

Space is limited.
Organization Information
Please list Cities and Counties Served by your Agency
Majority of Target Population Served (select up to two)

Other
Continuing Education Credits

Other
When downloading the material, will you be downloading in English, Spanish, or both?
How do parents contact your agency for services?
Please provide the best point of contact's phone number to contact your Agency
ex: 330-532-4503
Please provide the link to your Agency's Website or Business Page
ex: www.agencyname.com
How did you hear about us?

Other
Please provide the name of the person who referred you and their agency
Registrant Information
Participant Name

First NameLast Name
Participant Email
example@example.com
Participant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Participant Position Title
I'm registering more than one participant:
2nd Participant Name

First NameLast Name
2nd Participant Email
example@example.com
2nd Participant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
2nd Participant Position Title
3rd Participant Name

First NameLast Name
3rd Participant Email
example@example.com
3rd Participant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
3rd Participant Position Title
4th Participant Name

First NameLast Name
4th Participant Email
example@example.com
4th Participant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
4th Participant Position Title
5th Participant Name

First NameLast Name
5th Participant Email
example@example.com
5th Participant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
5th Participant Position Title
I'm registering more than 5 participants
Please add each additional participant's name, email, phone number, and position title - one participant per line.
Have any of the registered staff previously attended a Nurturing Families training?
If so, please indicate who utilizing their name, and what year they attended

Select from the available Training Dates

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Billing Email
example@example.com
Please verify that you are human
Should be Empty:

Facilitator Training Registration

How do parents contact your agency for services?

Select from the available Training Dates*

Select from the available Training Dates