tMHFA manual-instructor request
As a teen Mental Health First Aid Site (or a teen instructor on behalf of an approved site) you can request funding for:
  • teen manuals
  • new or additional instructors
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Site ID (if you do not have a Site ID assigned, please indicate below)
Organization or School District Name: *
Current Instructor/s
Shipping information: 
City, State, Zip
Phone Number
When do you plan to implement the course? (Manuals will be shipped prior to the semester you plan to implement. Please make sure someone from your site is able to receive this shipment.)
Which grade level(s) do you intend to train? Sites must agree to train an entire grade. Select all that apply.  *
I am requesting _______ teen manuals: (based on number of students you will train in that semester)
I am requesting a new/additional teen instructor. Please give us a short explanation.  (ex. my current instructor left our district, we have expanded the program, we are ready to have an instructor who is a school employee)
Instructor candidate Name, email, preferred training date
Please indicate which version of tMHFA your site plans to deliver:

In-person – Lessons are conducted in person in six 45-minute sessions or three 90-minute sessions.
Blended – Teens complete a self-paced online lesson, then participate in six live, Instructor-led sessions.   
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