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This event has only 30 space(s) left. If you continue and register more than 30 people (including yourself ), the whole group will be wait listed. Or, you can reduce the number of people you are registering to 30 to avoid being put on the waiting list.
How many people are you registering?
*
1
2
3
4
Fill in your registration information on this page. You will be able to enter the registration information for additional people after you complete this page and click "Continue".
Register Mental Health
First Name
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Last Name
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Email Address
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Street Address
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City
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State
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- select State/Province -
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Postal Code
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Cell Phone
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Do you need interpreter services? If yes, which language?
Apply for financial assistance
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ASIST Training
*
ASIST Training
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$ 100.00
Total for this participant
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