Youth Mental Health and First Aid

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Please complete the required sections of this form to register for the YMHFA course on April 14 (Section A) and 21(Section B); 2-6pm at Eastport United Methodist Church 926 Bay Ridge Ave. Annapolis, MD 21403.

If you are only available for one of the dates, we hope to offer a second set of both sections at a later date.

Questions? Email office@eastportumc.org

Email *

First and Last Name *

Zip Code *

Email Address (For communication and sending course materials) *

Phone Number *

Please answer one of the following (optional): Do you represent a specific organization or group interested in this topic? Are you attending as a parent, youth leader, community member, or something else? What role do you hope this course will play in your work or personal life?

I am interested in the course but not available for one or both of these dates and will need to attend one or both of the sections offered at a later date.

Yes

Other:

A copy of your responses will be emailed to the address you provided.

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