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Individual Sign Up for QPR Training Hosted @ Nuçi's Space
Contact Information
Name
*
First Name
Last Name
Pronouns
Email
*
Verify Email
*
Phone
*
County of Residence
*
select one
Athens-Clarke County
Barrow County
Jackson County
Madison County
Oconee County
Oglethorpe County
Other
Which of the following dates would you like to attend?
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Thursday May 23rd, 9:30a-12:00p
English and Spanish official QPR booklets are available - handouts/graphics and presentation will be in English.
*
Please select official booklet language version:
English
Spanish
Age Verification
*
Per QPR Institute guidelines, attendees must be at least 18 years of age. Potential attendees acknowledge:
I am 18 years of age or older.
I am NOT 18 years of age or older. I would like to learn more about QPR training for individuals under the age of 18.
How did you hear about us?
*
select one
Nuçi's Space website
Instagram
Facebook
Word of mouth
I am staff / volunteer at Nuçi's Space
Flagpole
NPR / WUGA
Reddit
Other
Any other notes?
