Mental Health Training for Juvenile Justice

Disclaimers

• Although it is unlikely, NCYOJ reserves the right to cancel training courses due to insufficient registration.
• Registration does not include travel or lodging. Breakfast and lunch will be provided each day of the training.

Complete the form below to become a certified trainer or to renew your certification:

Select an Application Type:

Re-Certification

$1,450.00

For individuals that participated in an NCYOJ Train-the-Trainer in the past and would like a refresher.

New Trainer

$1,950.00

For individuals that have never participated in an NCYOJ Train-the-Trainer.

Contact Information:

First Name *

Last Name *

Title *

Agency *

Years at Agency *

Phone Number *

Email Address *

Street Address *

PO Box, Suite Number, etc.

City *

State * Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Terr. Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Ed. Is. Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory

Zip *

Please describe your current position and how you intend to
utilize this curriculum * (mandatory for New Trainers and Re-Certification only) Max characters: 200

Please let us know if you have dietary restrictions or require other special accommodations. (optional)

Complete application with:

OR

Mail-In Payment