CABLE Peer Support Registration

Monday, October 21, 2024 - Friday, October 25, 2024

8:00 AM-4:00 PM

VA Hospital, 55 Willard Avenue, Newington CT

$319.00 per attendee - CISM & Advanced Peer Support (10/21-10/25)

Three-day option for those who already have CISM Certification

$169.00 - Advanced Peer Support ONLY (10/23-10/25)

Click here for more information on the course, including information about who should attend.

Please note: this training is limited to active first responders (police, fire, EMS, dispatch) in the State of Connecticut. Individuals not meeting this criteria should email training@cablect.com to inquire about eligibility before registering for training.

I am registering *

Just myself

Someone else from my agency

Myself & Others

First Name (individual completing registration) *

Last Name (individual completing registration) *

Name of Agency/Organization *

Agency Address *

City *

State/Province *

Zip/Postal Code *

Work Phone *

Email Address *

How many people are you registering? *

What are you registering for? *

Full Week - CISM & Advanced Peer Support Training - 10/21-10/25- $319.00

3 day - Advanced Peer Support ONLY (10/23-10/25) - $169.00

Does your department have a Peer Support coordinator? *

Yes

No

N/A

If yes, what is the individual's name?

Peer Support Coordinator Email

Does your department/agency have a training officer/coordinator? *

Yes

No

N/A

Please provide the name of your department's training officer

Training Officer Email Address

Participant Information

First Name - Participant *

Last Name - Participant *

Participant Email Address *

Job Title/Position *

Add Another Participant

First Name - Participant *

Last Name - Participant *

Participant Email Address *

Job Title/Position *

Add another participant?

First Name - Participant *

Last Name - Participant *

Participant Email Address *

Job Title/Position *

Add another participant?

First Name - Participant *

Last Name - Participant *

Participant Email Address *

Job Title/Position *

Add another participant?

First Name - Participant *

Last Name - Participant *

Participant Email Address *

Job Title/Position *

How will you be paying? *

Online Payment - Credit/Debit Card

Please invoice (click "pay by check" on next screen)

I have a registration code

Please provide any specific instructions for invoicing. If left blank, the invoice will be emailed to the individual completing registration.

If you have a registration discount code, please enter it here.

Please include any special instructions/information related to this registration, if needed.

Registrations may be cancelled/refunded and/or participants may be rescheduled for an alternate training session up until 7 days prior to the course start. No shows and cancellations occurring after this point will not be eligible for a refund or postponement/application of funds towards a future class. A registered participant may be replaced/swapped with another participant from the same agency for the same training class without penalty up until the start of the training class. *

I have reviewed the cancellation policy and wish to continue with registration.