Dates: Thursday, June
14, 2012 9:00 am – 4:30 pm
Friday, June
15, 2012 9:00 am – 4:30 pm
Location: MHAST- 153 Court Street – Binghamton, NY 13901
Registration Deadline is Wednesday, June 6, 2012 (No refunds
after this date)
Name:
_____________________________________________________________________
Agency/Company
Name:
______________________________________________________
Agency/Company
Address:
_____________________________________________________
_____________________________________________________
Email:
______________________________________________________________________
Phone:
______________________________________________________________________
Cost: $90.00 per person.
(Make checks payable to Mental Health
Association of the Southern Tier)
Cost includes MHFA Course Booklet, breakfast and lunch (both
days).
Participants MUST
attend the two full days of training to receive the certificate.
Any questions, contact Keith Leahey
(keith.leahey@youmha.com) or Dawn Kirk (dawn.kirk@yourmha.com)
Or at (607) 771-8888.
Mail completed form to: Mental Health Association of the
Southern Tier
Attn:
Mental Health First Aid
153
Court Street, Binghamton NY 13901
Or- Fax: (607) 771-8892
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