Youth Mental Health Virtual Training April Interest Form

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Space is limited to 15 individuals per session.
Once this interest form has been completed you will be contacted by Ms. Karla Garza to register for training.
If you have any questions please contact us at:
kgarza@mrgbahec.org
(956) 712-0037

Full Name *

Organization *

Mailing Address (include city, state, and zip code) *

Work Phone Number *

Cell Phone Number *

Email address *

Profession *

Nurse

Social Workers

Counselors

Other (Non-CEU's)

Are you 18 or older? *

Yes

Select Date (If no date is available registration has closed. Please contact kgarza@mrgbahec.org for more information.) *

If a CEU date is chosen and you are interested in obtaining the CEU please pay the $25 fee at www.mrgbahec.org under the donation button for credit payment. For all other forms of payment please mail or visit us at 1505 Calle del Norte, Ste. 430 Laredo, TX 78041

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