Registration: Hiring and Leading Staff in Evidence-Based Practices 9.2.1

Name*

First Last

Credentials*

Agency/Organization*

Current Position*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Work Phone Number

Cell Phone Number

(NFARtec Staff will be sending weekly SMS text messages related to course content. By registering for the series, you consent to receive text messages sent through an automated system. Once the messages are sent, text STOP to opt out)

Email Address*

Enter Email Confirm Email

Password*

Enter Password Confirm Password

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Type of Continuing Education Requested (check all that apply)*

License/Certification Number (Required for ISAP’s PSY/RN approvals)*

Languages Spoken Fluently*

Are you currently providing treatment and/or recovery services in the behavioral health field?*

Yes
No

Do you have a background in or have you attended leadership and/or evidence-based practice implementation training in the past?*

Yes
No

If yes, please explain*

What do you hope to learn by taking the Hiring & Leading Staff in EBPs series? (Open ended)*

How did you learn about this event? (Open ended)*

By checking here you are indicating that you understand the expectations and technology requirements as well as the time commitment to participate in this training.*

I understand the time commitment involved and agree to fully participate.