Adult Mental Health First Aid (MHFA) Registration

Thursday, January 22, 2026

Name(Required)

First Last

Email(Required)

Phone (optional)

Date of Birth(Required)

Please choose a class(Required)

Thursday, January 22 2026 from 9am - 4:30pm

Accommodation Needs (optional)

Please list any dietary restrictions

How did you hear about this class?(Required)

Where did you hear about this class?(Required)

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Adult MHFA Class Fee(Required)

Price:

Subtotal

$0.00

Sales Tax

$0.00

Total

Credit Card

Card Details

Cardholder Name