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Training Request Form
Organization Name
(Required)
Date
(Required)
MM slash DD slash YYYY
Point of Contact Name
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Name
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Phone
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For In Person Only: Address Where Training Will Take Place
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Address Line 2
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Course Information
Course Type
(Required)
Select the course(s) you would like to receive. Attendees must be 18 years of age to attend.
Mental Health First Aid - Adult (In-Person)
Mental Health First Aid - Adult (Virtual)
Mental Health First Aid - Youth (Course for adults who work with youth) (In-Person)
Mental Health First Aid - Youth (Course for adults who work with youth) (Virtual)
Mental Health First Aid - Teen (Age 15-18yrs) (In-Person Only)
Mental Health Awareness & Suicide Prevention Resources (In-Person)
Mental Health Awareness & Suicide Prevention Resources (Virtual)
LGBTQ+ Suicide Prevention (In-Person)
LGBTQ+ Suicide Prevention (Virtual)
De-escalation and Debriefing (In-Person)
De-escalation and Debriefing (Virtual)
Trauma-Informed Care (In-Person)
Trauma-Informed Care (Virtual)
Compassion Fatigue and Self-Care (In-Person)
Compassion Fatigue and Self-Care (Virtual)
Improv for Crisis Workers (In-Person)
Improv for Crisis Workers (Virtual)
Proposed Dates
(Required)
MM slash DD slash YYYY
please suggest three, minimum of one month in advance
Proposed Dates
(Required)
MM slash DD slash YYYY
please suggest three, minimum of one month in advance
Proposed Dates
(Required)
MM slash DD slash YYYY
please suggest three, minimum of one month in advance
Proposed Start Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Projected Attendance
(Required)
Please enter a number from
15
to
30
.
minimum = 15, and maximum = 30 for each course
Solari will provide you with a marketing flyer and registration link for the course. Would you like the course open for public attendance?
(Required)
Yes
No
In Person Facility Requirements (skip if course is virtual)
Trainers will arrive on site one hour prior to course start time. Please prepare to have someone available to open the building/room. Trainers will provide all class materials (paper, pens, fidget toys, manuals and handouts) and can bring equipment if needed
Does your training room have:
Projector
Speakers
Post-it Easel or White Board
None
Does your training room comfortably hold up to 30 people and can the room be set up in small groups or classroom style?
Yes
No
Does your building have specific security measures we should plan for?
Name
This field is for validation purposes and should be left unchanged.
Training Contact:
Stacy Cassens
Email:
@Stacy.Cassens@solari-inc.org