Advanced Parent Leadership Pre-Registration Next Training Sept. 5th- 7th

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Pre-Registration to attend Advanced Parent Leadership Training offered free from Virginia Family Network.

Name First and Last *

Home Address ( Street, City, State, Zip) *

Email Address *

Phone Number *

Are you a parent/primary caregiver of a child/youth/young adult who had a mental health challenge? I am a ..... *

Parent

Primary caregiver

Grandparent

Foster Parent

Adoptive Parent

Kinship primary cargiver

Other:

Did your child begin to experience these mental health needs before the age of 18? *

Yes

Are you connected with your local NAMI affiliate? *

Don't know who my affiliate is

Yes

Have you ever been to any other Virginia Family Network or NAMI Virgina trainings, workshops or events?

Yes, 1-2

Yes, 3-6

Yes, 7-10

Yes, More then 10

Clear selection

Have you ever attended any of the following events hosted by NAMI Virginia? *

NAMI Basics

Children Challenging Behaviors

Family and Youth Leadership Summit

Parent Support Group

Another VFN training

Other

None

Required

Why are you interested in attending this training? *

What has been your experience with navigating the children's mental health care system? *

Do you have experience being a Family Leader? *

Maybe

Yes, I am a Family Support Partner

Yes, I am a Peer Recovery Specialist

Yes, I am a parent representative on a FAPT, CPMT or other work group

Yes, I am a VFN Volunteer

Other:

Do you feel like you have support outside of the people you live with?

Yes

Maybe

Clear selection

I feel confident that I have the skills to manage challenges.

Fully Confident

Not confident at all

Clear selection

By taking this training, our hope is that you commit to at least one of the leadership opportunities below. Of course, we understand that things come up or it's not always possible. However, please check off which opportunity or opportunities are of interest to you. *

Lead a parent support group in your community

Train other parents and professionals on topics related to the voices and needs of families and youth

Provide individual support and education to other parents

Speak at budget hearings, legislative events

Speak to the media

Serve on your local CSB Board, FAPT, CPMT, and other community committees

Provide expertise or perspective at meetings, conferences, panels, etc.

Serve on the VFN Advisory Board

Other:

Required

Are you aware this is a virtual online via Zoom Training for three days?

Yes

Clear selection

I am aware to complete registration for this training, I need to schedule a short phone call with the Virginia Family Network Program Manager Nicole Anjum. An email will be sent to start this conversation.

Yes

Clear selection

Thank you very much for your application! We will be in touch shortly to follow up, address any questions you have and confirm your attendance. In the meantime, let us know if you have any questions or need to provide any additional information. Thank you again!

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