August 2026 ICISF Training Application: Pittsfield, IL

  • August 2026 ICISF Training Application

    3 Day training is a combination of ICISF's Individual Crisis Intervention and Group Crisis Intervention in Pittsfield, IL, August 3-5, 2026.

  • The 100 Club of Illinois is excited to offer the ICISF Individual and Group Crisis Intervention 3 day training free of cost (for first responders) to promote the sustainability of department and first responder critical incident resources. This course has limited seats available and a participant application is required to be considered to attend. Course seats are being held for applicants who have a strong working knowledge of the first responder culture and who will be able to implement their training immdediately through critical incident call outs and/or peer support responses. 

    Please see the course flyer and website for details of the training. If you are unable to attend all three training days, please do not register for the course. Attendance for all 3 days is required.

    We ask that you complete the following application in full to help us get to know you, your (or your department) needs, and your goals with fulfilling this course. Some of the questions asked in this form are for attendee grant tracking purposes and will assist with training evaluation needs. 

    Please Note: Clinicians who are not directly affiliated with a department or who do not have the endorsement of a CISM team will be assessed the following registration fees:

    $300 for the Individual Crisis Intervention course
    $300 for the Group Crisis Intervention course
    $500 for both courses (full 4-day training)

    If you have any questions regarding the course, application, 100 Club, or your department programming needs, please contact Meg Krase at mkrase@100clubil.org. 

    Thank you!

     

     

  • Individual Information

  • Format: (000) 000-0000.
  • Are you currently:*
  • What line(s) of work do you serve in?*
  • Your First Responder Wellness Role(s)*
  • Age:*
  • Race: (select all that apply)*
  • Gender:*

  • Agency Information

    Please provide information about the agency you work for
  • Current Agency First Responder Wellness Programs*

  • Training Commitment

    Help us ensure seats are filled with available attendees
  • Are you available to attend all 3 days in-full of the training dates listed?*
  • Are you able to provide your own transportation and lodging accommodations as needed (financially and time) to attend this training?*
  • Should be Empty: