Youth Mental Health First Aid Training Request Form for "Youth" Leaders

Mental Health First Aid Training Request Form for Youth Leaders and Parents

This is a virtual program
If you would like to request a Mental Health First Aid Training for Youth Leaders or Parents, below are points to consider:
- The class is virtual and requires a computer and computer skills to attend online, register, fill out a pre- and post-evaluation form, and take a quiz on line.
- The on-site class lasts 6 hours. The class will be completed in 2 days, 3 hours/day. Participants must attend both days and for the entire duration to obtain certification. If you leave during the training, you can reenroll in another class in the near future to obtain credit.
- This course is a secular course that will also have a Catholic spiritual perspective.
- The class size will be a minimum of 5 and a maximum of 30 participants.
- The course is free (a value of $179.00).
- The updated manual and guide used for this class can be downloaded once you enroll in the class. However, if you would like to obtain a hard copy of last year's manual, you can request to pick one up at the Diocese of Phoenix by contacting Lety Assad at 602.354.2115 or emailing at lassad@dphx.org.
- Once you submit this request, you will hear from the instructor Rebekah Johnson, 2-3 weeks before the class starts to enroll in MHFA. If you do not receive an email message please reach out to Lety Assad: lassad@dphx.org.
We look forward to receiving your response! If you are an individual, please fill out the top portion of the page. If you are requesting training for your parish, please fill out the bottom part of form. Thank you!

SIGN UP BELOW:
I AM REGISTERING AS:*

an individual for virtual MHFA-Youth class
Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
I am a *
I am at least 18 years of age or older.*

YesNo
Parish/Organization Name *
Parish/Organization Address (optional)
I would like to attend on the following date (only one class date available at this time). *
How did you find out about this course? *
Upon receipt of this form, Mental Health Ministry will submit your information to the instructor, Rebekah Johnson. In turn, she will contact you, via email, 2-3 weeks before the start of the class date. If you have any questions. Please keep an eye for the next email from MHFA.

Questions? Please email: lassad@dphx.org or call 602.354.2115. Lety Beltran Assad
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Mental Health First Aid Training Request Form for Youth Leaders and Parents