It appears that you did not come to this form from the Plumas Rural Services website.
To ensure your registration is accurate please go to the following link and select the date you wish to register for.
You are registering for the class to be held August 28, 2019 from 9:00am to 12:30pm.
Participants between the ages of 15 and 17 can attend if a Parental Consent Form signed by parent/guardian is provided.
You are registering for the class to be held September 5, 2019 from 9:00am to 12:30pm.
You are registering for the class to be held September 10, 2019 from 9:00am to 12:30pm.
3) I understand that this course is funded by a SAMHSA Mental Health Awareness Training grant and is provided at no cost to participants. I understand that there is a requirement for the grantee (Plumas Rural Services) to collect data following the course to determine the effectiveness of the training and how it has been implemented. For this training, the data collection includes completing a short quarterly follow-up email survey (1-5 minutes to complete). I understand that this is voluntary and my decision to participate or not will not affect my access to services, including training.
4) I understand that during this training we will be discussing topics and sharing experiences related to different aspects of mental health, including suicide. I understand that these topics could prompt some psychological and emotional reactions or distress for me such as anxiety, sadness, anger and grief; I understand that support and resources will be available to me should I require it.
There's an error. We cannot tell if you are under 18 or not. Correct your response to either question 2 or 4.Once corrected, this notice will be removed.
A Parental Consent form will be emailed to you as an attachment upon the completion of this registration. Please ensure the form is completed and signed by your parent/guardian.
The form can be sent to:
Fax: (530)283-3647 (Please send to the attention of Tammy Masters)
Drop Off or Mail:
Plumas Rural Services
711 East Main Street
Quincy, CA 95971
If you or your parent/guardian have any questions, please call (530)283-2735 ext. 882
This message will be included in the return email once this registration is submitted.