ASIST Training Scholarship Application 
ASIST is a 2-day training program that teaches participants how to assist those at risk for suicide.
May 18th  AND19th from 8am - 4pm in PHOENIX. 
PFCA is offering scholarships of $200 for individuals selected from this application. PFCA will notify applicants within 14 days of application completion. 

THIS TRAINING IS IN PERSON. 
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Name *
Email *
Organization *
Please share why you'd like to be accepted for this training scholarship of $200 to complete the ASIST training.  *
I understand if accepted for the scholarship of $200 that I will be required to attend BOTH days of May 18th and 19th from 8am - 4pm. This training will be IN PERSON. *
ضروری
I understand that the ASIST training will be discussing sensitive topics including Suicide, and I acknowledge that I am responsible for my own self care and wellness to attend. I agree that I am currently in an emotionally well space to attend.  *
ضروری
Dietary restrictions or allergies *
I understand that this application will be reviewed by PFCA staff, if selected I will be registered for the ASIST training on May 18th - 19th from 8am - 4pm. PFCA will cover my $200 training fee.  *
ضروری
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