Full name of person filing this request for instructor training: *
Your answer
Which of the following best describes you? (please select all that apply, or opt out) *
Required
Which organization do you represent? What is your title? *
Your answer
Which version(s) of the Mental Health First Aid instructor training interests you? *
Required
Location Preference of Instructor Training
If certified, will you (or the prospective MHFA Instructor) be permitted to train individuals outside of your organization? *
Will your current organization be supporting your (or the prospective instructor's) role as MHFA Instructor? *
In which Oregon county/counties will trainings be provided? (select all that apply) *
Required
Is the need for this training time-sensitive? If so, what is your timeline?
Your answer
Who is the intended audience that you are planning to train? (For example: veterans, individuals in public safety, educators, older adults, Spanish speakers, etc.) *
Your answer
Is this training request for you, or for others? *