LIFE IS SACRED Training Application

Application Form

YSAC's Life is Sacred program is a 1.5 day suicide prevention/life promotion training program designed for front line workers/helpers to better understand some of the underlying reasons around suicide. This training program will help front line workers/helpers identify and build protective factors and resources around those they work with to better support, protect and prevent suicide. This training program is also geared to build greater knowledge which significantly increases worker/helper confidence in the field of suicide prevention and life promotion.

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* 1. Who is requesting this training?

Treatment Centre

First Nation

Educational Institution (Note: Facilitation and Travel Costs are applicable)

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* 2. Name of Treatment Centre/First Nation/Educational Institution

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* 3. Contact Person requesting the Training:

Name

First Nation/Community/Organization

Address

City/Town

Province

Postal Code

Email Address

Phone Number

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* 4. Preferred dates for the Training (2 consecutive days)

Date

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* 5. Location where the Training is to be held (Facility Name & Address)

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* 6. Approximately how many participants will be in attendance (25 maximum preferred)

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* 7. Has there been any suicide attempts in your community within the last 3 months?

Yes

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* 8. Has there been any recent deaths by suicide in your community in the last 3 months?

Yes

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* 9. As parts of this training could be triggering, it is important that participants have mental health and cultural supports available to support them in working through their feelings. Who will be your Mental Health Support Person in Attendance (Name, Position)

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* 10. Who will be your Cultural Support Person in Attendance (Name)

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* 11. In the spirit of partnership and collaboration, YSAC provides this training for free (with the exception for Educational Institutions). Therefore, it is the expectation that the host will provide the following in-kind services for the Training:
a) The facility/space for the training
b) Mental Health support for the participants
c) Cultural support for the participants
d) Interpreters for the participants if required
e) Lunch and snacks (am & pm) for the two days of training
Does your Treatment Centre/First Nation agree to do this?

Yes

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* 12. Does the facility/space have access to high speed internet?

Yes