YAS Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This form is for Young Adult Strategies (YAS) programs. A program that provides strategies to thrive in life with a focus on building resilience. Workshops provide strategies and tools for stress management, coping, overcoming obstacles, personal development and supports for substance misuse. Please fill out completely

First Name *

Last Name *

Email *

Phone Number

What town do you live in? *

Atkinson

Auburn

Candia

Chester

Danville

Derry

Hampstead

Hooksett

Litchfield

Londonderry

Plaistow

Salem

Sandown

Windham

Other:

Which workshop are you registering for? *

Self Care How-To- create a personal plan for stress management and a healthy mindset Friday on Zoom 12:00 - 12:45

Building Your Recovery Capital - build upon recovery skills & relapse prevention Friday on Zoom 12:00 - 12:45

The Resilience Factor- overcome obstacles, cope with stress, build a healthy mindset

Thriving Through Stress - Stress management skills & tools

Workplace Wellness

Other:

Who or what agency referred you to this program?

Self referral / found the program myself

Referred by friend or another attendee

School referral

Medical professional

Social worker

DCYF

Other:

Clear selection

Age

Topics you are interested in:

Stress

Healthy Lifestyle Strategies

Substance Misuse Education or Support

Self-Esteem

Empowering Mindset

Other:

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms