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First Name

Last Name

Organisation's Name

Type of organisation

School or youth organisation
College or University
Company
Charity or not for profit

Work Email Address

Work Phone Number

Work postcode?

Work Address Line 2

Who is the training for?

All staff
Teaching staff
Students

Who is the training for?

Line manager
Employees
Both

Please note we advise that all staff should receive training on mental health, and staff training is recommended before Charlie Waller delivers sessions to students.

Have the staff received mental health training before?

No
Yes

Please provide details of previous training

How many people attended?

Do you know what topics you would like covered in the training?

No
Yes

Please provide details of the training required

Would you like in person or virtual training?

In person
Online

What do you hope to achieve with this training?

Any further information?

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