QPR Registration - Suicide Prevention Training Oct. 18th at 5pm

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The WYCC is inviting the public to take part to raise awareness and prevent suicide. The training will be done by Ryan Nesbit, Co-Director of “Alive and Running Iowa.” It will focus on how to Question, Persuade and Refer (QPR) people showing signs of suicidal thoughts. The training will take place on October 18th 5-7pm at the Waterloo Center for the Arts. Donations are accepted but not required, all donations will go towards helping youth mental health.

PLEASE FILL OUT A SEPERATE FORM FOR EACH ATTENDEE

If you have any questions or you need help registering, please contact Glen Keith at gpkeith2@gmail.com

You can find out more about QPR at https://www.aliveandrunningiowa.com/qpr/

First and Last Name *

Email Address

Phone Contact XXX-XXX-XXXX format please

What best describes you? *

I'm a high school student

I'm a college student

I'm an adult

I'm an adult with school age children (child)

I'm an adult with adult children (child)

Other:

What high school am I associated with (attend, parent of a student) or none at all

Columbus High

East High

Expo High

Home School

West High

Valley Lutheran

Waterloo Christian

Not Associated with any high school

Other:

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms