Training Registration Name(Required) First Last Phone(Required)Email(Required) Agency/Organization (if applicable)Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County(Required)AllenAndersonAtchisonBarberBartonBourbonBrownButlerChaseChautauquaCherokeeCheyenneClarkClayCloudCoffeyComancheCowleyCrawfordDecaturDickinsonDoniphanDouglasEdwardsElkEllisEllsworthFinneyFordFranklinGearyGoveGrahamGrantGrayGreeleyGreenwoodHamiltonHarperHarveyHaskellHodgemanJacksonJeffersonJewellJohnsonKearnyKingmanKiowaLabetteLaneLeavenworthLincolnLinnLoganLyonMarionMarshallMcPhersonMeadeMiamiMitchellMontgomeryMorrisMortonNemahaNeoshoNessNortonOsageOsborneOttawaPawneePhillipsPottawatomiePrattRawlinsRenoRepublicRiceRileyRooksRushRussellSalineScottSedgwickSewardShawneeSheridanShermanSmithStaffordStantonStevensSumnerThomasTregoWabaunseeWallaceWashingtonWichitaWilsonWoodsonWyandotteWhich training are you registering for?(Required) Youth Mental Health First Aid (YMHFA) Question, Persuade, Refer (QPR) Applied Suicide Intervention Skills Training (ASIST) Youth Mental Health First Aid (YMHFA) YMHFA teaches participants how to identify, understand, and respond to signs of mental health and substance use challenges among children and adolescents ages 12-18, how to respond to a crisis, and how to connect them to help. YMHFA is designed for any adult who works with youth or has young people in their lives. This training is 8 hours and can be done virtually or in person. Question, Persuade, Refer (QPR) QPR is an emergency mental health intervention training to give community members the tools to aid a person in a suicidal crisis and direct the person to proper care. QPR is designed for anyone interested in being able to help a suicidal person. This training is 1 hour and can be done virtually or in person. Applied Suicide Intervention Skills Training (ASIST) For anyone 16 years of age or older who want to feel more comfortable, confident and competent in helping to prevent the immediate risk of suicide. ASIST is a resource for the whole community. It helps people apply suicide first-aid in many settings: with family, friends, co-workers, teammates and formal caregiving roles. This is a two day in-person, in-depth training.If you are interested in an ASIST training, please email Sue Murnane at smurnane@acmhck.org. Thank you! ASIST Trainings will be 6/5-6/6 in Garden City 6/19-6/20 in Hays 6/15-6/16 in Parsons Youth Mental Health First Aid(Required) June 20th - 9:00 AM-5:00 PM - Garden City Question, Persuade, Refer (QPR)(Required) April 25th – 12:00-2:00 PM - Topeka - DCCCA Building May 6th - 11:00 AM-1:00 PM - Girard - Greenbush May 30th - 12:00-2:00 PM - Hays - Fort Hays State University June 2nd - 9:00-11:00 AM - Dodge City - Depot Theater June 5th - 11:00 AM-1:00 PM - Wichita - DCCCA Gym How did you hear about this training?(Required)Do you require any accommodations to participate in this training?(Required)Questions, comments, concerns?
