Youth Mental Health First Aid Training - Registration Form
Location: Stawell
Day 1: 15th of September
Day 2: 22nd of September
Name
*
First Name
Last Name
Gender
*
Female
Male
Trans Female
Trans Male
Non-Binary
Gender Fluid
Prefer not to say
Do you identify as Aboriginal or Torres Strait Islander
*
Aboriginal
Torres Strait Islander
Both Aboriginal and Torres Strait Islander
Nether Aboriginal or Torres Strait Islander
Main cultural background other than ATSI?
*
Language other than English that is spoke. Is an interpreter required?
*
Contact Information
Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
Email
*
example@example.com
Emergency Contact
Details
*
Full name
Relationship
Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
Additional Questions
Please answer the following questions to the best of your ability
What is the primary reason for you completing the Youth Mental Health First Aid Training?
*
What are you hoping to learn from the Youth Mental Health First Aid Training?
*
During the YMHFA training there will be a number of topics discussed that can be confronting to some participants. Do you feel that you may need additional support due to impactful lived experience? If yes , what ways can we support your needs?
*
Do you have any additional needs that facilitators need to be aware of such as physical disability, learning disability, etc.
*
Do you have any dietary requirements? If yes, please list them below
*
Submit
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