Healthy Communication: Parents and Children Training Registration

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This training session will take place via Zoom on Tuesday, April 23rd from 6:00 pm to 7:30 pm. You will receive a training confirmation and Zoom link closer to the training date.

Full Name *

Email *

Which of the following best describes your age? Select one.

Under 18

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 and over

Clear selection

Which of the following genders do you most identify with? Select one.

Male

Female

Transgender

Non-binary

Prefer not to say

Other

Clear selection

Which of the following best describes you? Select all that apply.

Asian

Black or African American

Hispanic or Latino

Native American or Alaska Native

Native Hawaiian or Pacific Islander

White

Other:

What is the highest level of education you have completed? Select one.

Some high school, no diploma

High school diploma or GED

Some college, no degree

Associate (2-year) degree

Bachelor’s (4-year) degree

Master’s degree

Doctorate degree

Clear selection

Please list your current occupation if applicable.

Please select the city in which you currently live. *

Ayden

Bethel

Falkland

Farmville

Greenville

Winterville

Grimesland

Other:

Are you a Thriving Families participant?

Yes

Clear selection

If you are not a Thriving Families participant, would you like more information on this program?

Yes

Maybe later

Clear selection

What do you hope to learn from this training?

Submit

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