MHFA Training Request Form
Please be sure to check our most current listing of available trainings under the 'Mental Health First Aid' section of our website before requesting a training for your organization.

Philly MHFA encourages all Philadelphians to utilize our amazing network of Community Hubs to access FREE MHFA trainings available across the city all month long. However, we have a cadre of individuals who would love to bring the training to you!

Our training team is comprised of over 200 volunteer instructors who give their time and energy to conduct MHFA trainings. In order to best match your training audience with instructors from our volunteer instructor pool, we ask that each organization guarantee at least 15 participants; provide three (3) possible training dates at least 4-6 weeks in advance and allow for up to two (2) weeks after submission to receive a final confirmation from the Philly MHFA team.

If you have any questions about the process or would like further information, please contact our office at 215.685.3755 or email us at mhfa_philly@pmhcc.org.

Thank you for your interest in MHFA!

Curriculum
Which course would you like to take?
Modules Coming Soon!
These modules will be made available soon. If your organization is interested in getting trained in one of these modules, let us know and a Philly MHFA representative will contact you with further information.
Name of Organization
Your answer
Contact Person Name and Title
Your answer
Contact Person Email
Your answer
Contact Person Phone Number
Your answer
Day of Training Contact Person Name and Phone # (if different)
Your answer
Training Location
Please provide full address including zip code as well as floor, conference room, etc... (Ex. 123 S. Algee St. 22nd Floor Conference Center, Philadelphia, PA 19109)
Your answer
Training Session Format
Preferred Date(s)
(Must be at least 4-6 weeks from date of submission for General Adult/Youth, 6-8 weeks for Modules)
MM
/
DD
/
YYYY
Start Time
MHFA is a 8 hour content course. Schedules must include additional time for necessary breaks
Time
:
End Time
Time
:
Date # 2
(Must be at least 4-6 weeks from date of submission for General Adult/Youth, 6-8 weeks for Modules)
MM
/
DD
/
YYYY
Start Time
MHFA is a 8 hour content course. Schedules must include additional time for necessary breaks
Time
:
End Time
Time
:
Date # 3
(Must be at least 4-6 weeks from date of submission for General Adult/Youth, 6-8 weeks for Modules)
MM
/
DD
/
YYYY
Start Time
MHFA is a 8 hour content course. Schedules must include additional time for necessary breaks
Time
:
End Time
Time
:
Anticipated Number of Participants
minimum of 15, not to exceed 35
Your answer
Training Equipment/Materials Provided
Please check all that you can supply
Required
Location Details
Please check all that pertains to your training location
Required
Other Notes (What else is important for the Philly MHFA team to know about your training request?)
If you are an instructor conducting the training, please indicate that in this section
Your answer
How did you hear about MHFA?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of PMHCC Incorporated. Report Abuse - Terms of Service - Additional Terms