Mental Health First Aid Training Registration Form | Connecticut Construction Industries Association

Mental Health First Aid Training

Wednesday, March 19, 2025 at the CCIA Training Room
9:00 a.m. to 4:00 p.m. (registration at 8:30 a.m.)

Instructors: Erica Skoutas (and TBD)

Company Name: *

Contact Name: *

Email: *

Please provide complete information for each person attending the training.

1. Full Name:

1. Email:

2. Full Name:

2. Email:

3. Full Name:

3. Email:

4. Full Name:

4. Email:

5. Full Name:

5. Email:

Cost: $150 per person (includes 6.35% CT sales tax).

Number Attending *

X $150 each = Total Amount Due. *

Payment Information: *

Mailing Check (payable to CCIA)

Credit Card Online (Click "submit form", then click "pay now" on the next screen.)

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