Youth Mental Health First Aid Training Registration Name* First Last Email* Phone*Organization/School Do you want CEUs from the training?* Yes No For which discipline/s would you seek CE/s for your participation in the training?Social Work (5.5 CEUs)Educators (5.5 CEUs)Training Registration Fee Price: Credit Card*Card Details Cardholder Name Billing Address* 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 Total $0.00 I agree to complete the self-paced pre-work for the Youth Mental Health First Aid training at least 1 day before the training. (NOTE: It takes about 2 hours for all pre-work to be completed)* Yes No, I will not be able to complete the pre-work prior to the day before the training starts (1 day before). Please let me know when this training is offered again. NameThis field is for validation purposes and should be left unchanged. Δ