VIRTUAL ADULT MENTAL HEALTH FIRST AID: April 28th – 29TH

OPEN Virtual Adult Mental Health First Aid

WHEN: Wednesday - April 28th & Thursday - April 29th, 5:00 PM to 8:00 PM (You must attend both classes to receive a Certificate.) WHERE: Zoom (An email with the Zoom link will be emailed to you closer to the class date.) Registration is Open to adult community members.

Name*

Email*

Phone Number*

Demographics

Demographics are NOT required, ut are used for grant and statistical purposes.

Age

18 & Under
18-25
26-40
41-54
55-74
75+

Gender

Male
Female
Prefer not to answer

Ethnicity

African-American
Asian/Pacific Islander
Bi-Racial
Caucasian
Hispanic
Native American
Other

Parent

Yes
No

If Yes - How many children?

If Yes - Ages of your children

0-5
6-10
11-15
16-18

Choose up to three sectors that you represent

vMHFA Registration: 04/28/2021, 04/29/2021

OPEN Virtual Adult Mental Health First Aid

Demographics