*1.Please enter your name:(Required.)

*2.Enter your workplace organization:(Required.)

*3.Enter your email address:(Required.)

4.What service areas in Maine do you plan to teach RBS for?

*5.Check this box to certify that your schedule allows you to attend both Train the Trainer classes
(It is required to attend all sessions. Makeup days cannot be be provided):
Day one: Tuesday August 20th, 9am-12:30pm
Day two: Thursday, August 22nd, 9am-12:30pm(Required.)

Yes, I am available to make all classes.

6.Do you require any learning accommodations to be comfortable and successful?
Please describe them below or email ellen.blake@maine.gov: