MHFA for Ag Community Registration Form
Event timing:

Part I is a self-paced (approx. 2-hour) online training that will need to be completed before part II. You will receive an invitation from "MHFA Connect" to set up your learner profile and access the self-paced portion.

Part II is a live, interactive skills course on Friday, MARCH 11th from 9:00 a.m. - 3:30 p.m. on Zoom. A webcam and microphone are required to participate. If you need assistance accessing high-speed internet or a computer, please call 608-339-4237 as soon as possible and no later than Mon, Mar. 7.

Space is limited to 25 participants.
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First Name *
Last Name *
Phone *
Email *
City *
State *
Zip code *
County *
Do you work in the field of agriculture/farming? (required by our funding organization) *
If you answered yes to the question above, please estimate how many farmers and farm family members you interact with in an average year.
Do you have any special needs for the virtual training?  If you are requesting accommodations such as captioning, sign language, etc., please fill out the accommodations form.  https://extension.wisc.edu/disability-accommodations/   
Have you taken the virtual or blended Youth Mental Health First Aid or Adult Mental Health First Aid course in the past?
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