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* 1. Please enter your name:

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* 2. Enter your workplace organization:

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* 3. Enter your email address:

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

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* 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

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

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