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NAMI San Mateo County- Basics Program Teacher Training
Please complete the following registration form in order to sign up for our upcoming Basics Leader Training.
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Full Name
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Your answer
Mailing address where you would like to receive your manual (please include city & zip code)
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Your answer
Your Phone Number
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Your answer
Your Email Address
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Your answer
This training is taking place virtually, do you have a computer/laptop, a reliable internet connection, and a quiet place to take this training?
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Yes
No
This training will take place from June 8th to June 10th.
6/8- 6 PM to 9 PM
6/9- 6 PM to 9 PM
6/10- 9 AM to 5 PM
Are you able to attend the full training?
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Yes
No
Maybe
Have you ever taken NAMI Basics?
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Yes
No
If yes, give your teacher’s name, location of class and date
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Your answer
If no, have you ever taken any other NAMI educational courses (NAMI Family-to -Family, NAMI Homefront, NAMI Peer-to-Peer, NAMI Provider Education)?
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Your answer
Are you a member of NAMI? If yes, list the affiliate you are connected with
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Your answer
Are you a member or facilitator of a support group?
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Yes
No
Are you a parent or other direct caregiver of a person who developed symptoms of a mental health condition before they were 13 years old?
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Yes
No
What is their relationship to you and what is the age of that person now?
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Your answer
Have they been diagnosed? If yes, what is their most recent diagnosis?
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Your answer
How long have they shown symptoms of a mental health condition?
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Your answer
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