A.S.I.S.T. Registration Form 2023

ASIST is a two-day intensive, interactive and practice-dominated course designed to help caregivers recognize and review risk, and intervene to prevent the immediate risk of suicide. It is by far the most widely used, acclaimed and researched suicide intervention training workshop in the world. ASIST prepares caregivers of all kinds to provide suicide first aid interventions.

Please Note: Registration does not ensure your acceptance into this course. Registrants who are not accepted will receive a full refund of the course fee.

While we do encourage anyone to take this livesaving course we'd like to ask that you should only sign up if you intend on attending the course in its entirety. There are limited spots and each seat which is not filled, is depriving the jewish community from a person knowledgable and skilled in suicide intervention.

Workshop Dates: March 1st & 2nd
Times: 9am - 5pm
Location: Crown Heights
Cost: $50

Registration must be completed 2 weeks prior to training.

Name*

First NameLast Name

Gender*

MaleFemale

Age*

Organization

Position

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

What do you plan on doing with the information and skills you learn in this course?*

Special Requirements

Important Workshop Details - Please Read:

This is a two day workshop. Workshop instruction starts at 9am and finishes by 5pm both days. Please ensure that you are able to attend both days for the entire time.
In this workshop you will have an opportunity to explore your experiences with and your attitudes about suicide. You will also have an opportunity to better understand the needs of a person at risk of suicide and learn how to use suicide first-aid to meet those needs. If these activities concern you, please talk to one of your trainers.
This workshop is restricted to persons over 18 years of age and requires a minimum of 8 registrants, maximum of 30 participants.

My Products

ASIST 2-day Course Fee

$50.00

Total

$0.00

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15 Contact hours are available for Social Workers and LMHC. Interested participants will be provided with a link at the end of the class with instructions on how to proceed including payment of the event fee and service fee totaling an additional $62.24
15 hours are also available upon completion of the workshop for current CASACs.
Registration Questions: email admin@neshamos.org
Suicide Prevention Center of New York (SPCNY), SW CPE is recognized by the New York State Education Departments State Board for Social Work as an Approved Provider of continuing education for licensed social workers #0384.
The Suicide Prevention Center of New York (SPCNY), is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors #MHC-0090.