Outreach, Presentation, & Training Request Form "*" indicates required fields Name* First Last EWU Email* Phone*Campus Role* Student Student Employee Staff Faculty Affiliation*Department, Office, Residence Hall, Organization, Club, Class, etc. Request Type*TrainingPresentationOutreachTablingAttendancePresentation Topic*Alcohol & Drug EducationSexual Health EducationInterpersonal Violence & Sexual Assault PreventionBystander InterventionHazing PreventionPhysical Health & WellbeingStress ManagementBody ImageSelf-CareOther (please specify)Other Presentation Topic*Outreach Request* Overview of Services Let's Talk Counselor Presence/Support Other (please specify) Please provide a brief explanation of your request for counselor presence/support.*Other Outreach Request*Requested Training* Mental Health First Aid (MHFA) QPR (Suicide Prevention) Naloxone (Opioid Overdose Prevention) Schedule Structure*Mental Health First Aid is an 8-hour training course that can be taught as one full day or two half days. Full Day (8AM-5PM) Half Days (8:30AM-1:30PM both days) Half Days (12PM-5PM both days) Date* MM slash DD slash YYYY Time* Hours : Minutes AM PM AM/PM Date (2nd Choice) MM slash DD slash YYYY Time (2nd Choice) Hours : Minutes AM PM AM/PM Half Day Training Date (Day 1)* MM slash DD slash YYYY Half Day Training Date (Day 2)* MM slash DD slash YYYY Audience* Students Student Employees Staff Faculty Expected # of Attendees*Most trainings/presentations have a minimum of 10. MHFA has a minimum of 8. Preferred LocationDue to specific set up and technology needs, we may need to reserve our own space, but please let us know if you have a preferred building/location and we will try our best to accommodate.Requested Tables* Counseling & Wellness Food Pantry Health Hut Eagles for Recovery Event Name*Event Date* MM slash DD slash YYYY Event Start Time* Hours : Minutes AM PM AM/PM Event End Time* Hours : Minutes AM PM AM/PM Location*RosterAll participants must attend all 8 hours of training. If you already have a roster, please include that below. First and last name along with email address is required. If not, this will need to be submitted to the MHFA coordinator at least one week before the class.Additional Information Δ