We are interested in bringing Mental Health First Aid to our organization...

We are interested in bringing Mental Health First Aid to our organization...
Thank you for your interest in Mental Health First Aid (MHFA)!

Our goal is to train as many people as possible because everyone deserves someone nearby who can recognize mental health challenges and connect them to support—at work, school, home, or in the community.

Currently, statewide funding for MHFA is on hold, but we have regional opportunities in select counties in Southwest Ohio, Northern Kentucky, and Athens County, Ohio for adult, youth and teen MHFA and are actively looking for more funding partners.

After you submit this form, we will:
- Contact you if your organization qualifies for one of the regional grants.
- Contact you to set up your paid class if you’re ready to move forward with purchasing MHFA training:
  - Youth or Adult MHFA: $2,400 per class for up to 30 participants
  - Teen MHFA: $1,850 per class for up to 30 participants
- Upon request, we will add you to the waiting list and contact you when funding becomes available in your area.
Thank you for making mental health support accessible to more communities!
Your Name*

First NameLast Name
Your Organization*
County*
State*
Your E-mail*
example@example.com
Your Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
How familiar are you with Mental Health First Aid?*
Are you interested in:*

Youth (youth serving adults who work with ages 12-18)Adult (for everyone 18 and up)Teen (14-18 year old to support their peers)Combination of curriculumsNot sure
Does your organization serve one of these communities? If so, which one best describes the audience your organization focuses on?

College Age (18-22)Older AdultsFaith-Based CommunitiesLGBTQ+Rural CommunityPeople with a Physical DisabilityPeople with Behavioral/Emotional DisabilityPeople with a Development DisabilityFirst ResponderCertified Peer Recovery SupporterYouth (12-18)BIPOC CommunityOther
*

College Age (18-22)Older AdultsFaith-Based CommunitiesLGBTQ+Rural CommunityPeople with a Physical DisabilityPeople with Behavioral/Emotional DisabilityPeople with a Development DisabilityFirst ResponderCertified Peer Recovery SupporterYouth (12-18)No, my organization does not serve one of the communities at least 50% of our time.Other
Does your organization serve one of these communities at least 50% of the time? If so, which one?*

Black/African AmericanHispanic/Latino(a) or Spanish OriginNative Hawaiian or other Pacific IslanderAsianAmerican Indian or Alaskan NativeMiddle Eastern or North AfricanNo, my organization does not serve one of the communities at least 50% of our time.Other
Let's see if you are eligible under one of our current grants:
Please check the counties that your organization serves in Kentucky: (Check all that apply)*

GallatinPendletonBrackenCampbellCarrollKentonOwenMasonLewisFlemingRowanRobertsonCarterGreenupWe don't serve any of these counties in Kentucky
Please check the counties that your organization serves in Ohio: (Check all that apply)*

AthensAdamsBrownButlerChampagneClarkClermontClintonGreeneHamiltonHighlandLoganMontgomeryPrebleWarrenWe don't serve any of these counties in Ohio
I don't qualify for current funding so please:

Add my organization to the waiting list and inform us if you get funding for my area.Set up a meeting as I'm interested in a paid class.Other
Would you like to be added to our waiting list?

Yes, please add me and let me know when you have funding.No thank you.I'm not sure. I'd like to meet with you first.Other
Please provide several dates and times that are convenient for you to meet.
Once we receive your availability, we will coordinate with our team and send you a Zoom link to confirm the final meeting schedule.
Please add any additional questions or comments about how we can help your organization.
Select an Appointment Date*
Additional Information/Comments*
Thank you again for contacting the MHFA Collaborative! We are looking forward to working with you!
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