Youth Mental Health First Aid Training Interest Form (Adults Only)

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This training is for adults only. The FREE training made possible by Montgomery County EveryMind and DHHS.

Priority for this training will be given to adults who are willing to support the Teen Mental Health First Aid Training class(es). The Teen version of YMHFA will be available soon.

All information shared here will be kept confidential.

Email *

First Name *

Last Name *

Phone Number (Please provide the best number to reach you in case of last minute openings, schedule changes, and course reminders.) *

Email (alternate)

Do you have a current student in MCPS? *

Yes

What school(s) do they attend? (No abbreviations, please.) Enter N/A if you do not have a student in MCPS. *

What grade-level(s)? Enter N/A if you do not have a student in MCPS. *

Would your student(s) likely be interested in the Teen Mental Health First Aid course to help their peers? *

Yes

Maybe

I do not have a student in MCPS

After your training, are you willing to assist trainers to deliver the Teen Mental Health First Aid course to students? *

Is there any particular experience or concern you feel makes this an urgent need for you and your family? (This information is for priority placement only and will remain confidential.) *

Are you interested and available to take the class on January 14th? (We have limited space available for these classes so please, only sign up if you are confident you can complete the pre-course work 2 days in advance and can attend the class. We appreciate your cooperation so we may accommodate as many families as possible. ) *

Yes

Please notify me of future classes.

Are you interested and available to take the class on February 24th? (We have limited space available for these classes so please, only sign up if you are confident you can complete the pre-course work 2 days in advance and can attend the class. We appreciate your cooperation so we may accommodate as many families as possible. ) *

Yes

Please notify me of future classes.

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