Typical or Troubled?® School Application Form
Hello and thank you for your interest in getting the Typical or Troubled?® Mental Health Professional Development training delivered to your school community. Please fill out this form to the best of your abilities. Once we have received your application an administrative staff member will review it.
Email address *
Contact Information
We want to know who is reaching out to us and who is the best person/people to contact within your school. The people that you provide us during this application will be the people that we will work with throughout the process of delivering the program materials. Please note that providing more then one person is helpful, in the case that staff turn over happens.
School Name *
Your answer
School Address *
Your answer
First and last name (Point of Contact) *
Your answer
Phone number (Point of Contact) *
Your answer
Email (Point of Contact) *
Your answer
First and Last Name (Secondary Point of Contact) *
Your answer
Phone Number (Secondary Point of Contact) *
Your answer
Email (Secondary Point of Contact) *
Your answer
City, State *
Your answer
School Demographics
We need to better understand the size of your student population and the size of the entire staff of your school. This training is gear to any staff member in middle and high school, so knowing how large a training will be helps us in the planning process.
How large is your student population? An estimate is fine. *
How large is your staff size? *
School Type 1 *
Required
School Type 2 *
Required
Are there specific dates you would like to receive this training? (Please list any dates below) *
Your answer
Referral System Information
This Professional Development helps staff to understand their role in connecting students to support services. We want to understand what support services you have available in the school and how you connect students to services if you do not have them in your school. If your school and community is lacking a referral system, please let us know. This will allow us to reach out to you directly to support you in building up those needed resources, before a training can be delivered.
Does your school have a system in place to monitor and track student referrals to mental health services *
Required
For each Referral Professional please list their names and titles. *
Your answer
Please explain briefly, the nature of your referral system. If one does not exist please explain how students get connected to support services. *
Your answer
Please provide any additional information that you would deem appropriate for administrative staff to know in selecting your school to receiving this training. *
Your answer
Funding Questions
We have one question to ask you regarding your funding for this program. This question does not impact your chances of receiving the training, it helps to inform us on how schools are planning to pay for mental health professional developments in their schools. It will also help to determine how we can help support schools that may be struggling to pay for professional development of their staff.
How will you pay for this professional development? *
Additional Information
Here are a couple additional questions for you to answer before you submit your application.
How did you find out about this Professional Development *
Would your school be comfortable having the training recorded for marketing purposes? *
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