2018 Mental Health Interpreter Training Registration

2019 Mental Health Interpreter Training Registration

Level I + II // July 15-16 2019 // Houston, TX
Participant Contact Information
Participant Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
Phone Number*

Area CodePhone Number
Primary Phone Location*

HomeCellWork
Primary Phone type (select all that apply)*

VoiceTextVideophone
Participant Employment Information
Hearing Status (Interpreters will be provided.)*

DeafHard-of-HearingHearing
Job Title/Position*
Employer*
Supervisor Email*
example@example.com
City in which you work
CEUs Requested

RIDBEILMSWLPC
Payment Information

In order to complete registration, you must submit payment by:

Check or Money Order ($50) can be mailed

Texas School or the Deaf
Attn: Cashier's Office
1102 S. Congress
Austin, TX 78704
**MHIT in memo line**

Credit/Debit Payments over the phone
512-256-4343 (VP)
512-462-5368 (Voice)

For more information about the

Texas Initiative for Mental Health for Deaf Youth:

https://texasdeafed.org/topics/mental-health-for-deaf-youth
Should be Empty:

2019 Mental Health Interpreter Training Registration