Challenging Stigma Training Report
Trainers: Please use this form to report any Challenging Stigma trainings that you delivered.
Trainer Name
*
First Name
Last Name
Organization
*
Email
*
example@example.com
Select region of your training
*
Region 1: Brooke, Hancock, Marshall, Ohio, Wetzel
Region 2: Berkeley, Grant, Hampshire, Hardy, Jefferson, Mineral, Morgan, Pendleton
Region 3: Calhoun, Jackson, Pleasants, Ritchie, Roane, Tyler, Wirt, Wood
Region 4: Barbour, Braxton, Doddridge, Gilmer, Harrison, Lewis, Marion, Monongalia, Preston, Randolph, Taylor, Tucker, Upshur
Region 5: Boone, Cabell, Clay, Kanawha, Lincoln, Logan, Mason, Mingo, Putnam, Wayne
Region 6: Fayette, Greenbrier, McDowell, Mercer, Monroe, Nicholas, Pocahontas, Raleigh, Summers, Webster, Wyoming
Statewide
Who was the target audience?
*
Number of participants
*
Training Date
*
-
Month
-
Day
Year
Date
How long was the training?
*
Was this training held in-person or virtually?
*
In-Person
Virtual
Hybrid - both in-person and virtual
Where was the training held? (include organization, location and city)
*
Comments or Questions?
Submit
Should be Empty: