Mental Health Awareness Training (MHAT) Request

Mental Health Awareness Training (MHAT) Request
Request Status
Scheduled Date

MonthDayYear
Date
Scheduled Time

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
View the full MHAT Catalog of Courses for detailed course descriptions.
RESA*
District*
Please select a training:*
- What is the expected number of participants? *
- Who is the intended audience for this training
  
  Educators/school staffOther
- Who will be attending the training? (Select all that apply)*
  
  District administrationTeacherSchool Social WorkerSchool administrationSchool nurseRESA staffSchool CounselorOther district staffOther school staffParaprofessionalTransportation staffOther
- Who will be attending the training? (Select all that apply)
  
  Community stakeholderParent/caregiverStudents (grade 6-8)Students (grade 9-12)Law enforcementHealthcare professionalMental health professionalOther
- Please select three date and time options for scheduling. The training provider will select the first available date.
  
  Please reference the course catalog for the description and duration of each course.
- Date Option 1 (Preferred)*
  
  MonthDayYear
  Date
  Hour MinutesAM/PM Option
- Date Option 2*
  
  MonthDayYear
  Date
  Hour MinutesAM/PM Option
- Date Option 3*
  
  MonthDayYear
  Date
  Hour MinutesAM/PM Option
- What training format do you prefer?*
  
  Virtual LiveIn Person
- Please list the address of the training site:*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Please provide any additional details/instructions here:
- Name*
  
  First NameLast Name
- Job Title*
- Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- Email*
  
  Confirmation Emailexample@example.com
- Is the training day point of contact the same as the requestor?*
  
  YesNo
- Please provide the contact information of the person that will be available on the day of training.
- Name*
  
  First NameLast Name
- Job Title*
- Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- Email*
  
  Confirmation Emailexample@example.com
- Please select a training:
- Please select a training:
- RESA Email
- Contractor Email
- MHAT Scheduling Email
- Should be Empty: