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SpeakUp!
Changing Lives One Conversation at a Time
About Us
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SpeakUp! Board of Directors
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Programs
Upcoming SpeakUp! Events
Active Partner Schools
Youth Mental Health First Aid
Parenting Adult Coffee Series
School Adult Discussions
QPR Trainings
Become a SpeakUp! School
Get Involved
Resources
About Us
About Us
Our Founder
Our Team
SpeakUp! Board of Directors
Contact Us
Programs
Programs
Upcoming SpeakUp! Events
Active Partner Schools
Youth Mental Health First Aid
Parenting Adult Coffee Series
School Adult Discussions
QPR Trainings
Become a SpeakUp! School
Get Involved
Resources
Facilitator Refresh
1
Event Select
2
Facilitator Information
Select Upcoming Event
*
-- Select Event --
23-24 SJP RETURNING Facilitator Refresh
23-24 RMS RETURNING Facilitator Refresh
23-24 CCTEC RETURNING Facilitator Refresh
23-24 ANDUS RETURNING Facilitator Refresh
23-24 DPHS RETURNING Facilitator Refresh
23-24 MPHS RETURNING Facilitator Refresh
23-24 VMA RETURNING Facilitator Refresh
23-24 SCJN RETURNING Facilitator Refresh
23-24 SKS RETURNING Facilitator Refresh
23-24 UTMS RETURNING Facilitator Refresh
23-24 SAP RETURNING Facilitator Refresh
Name
*
First
Last
Address
*
Please enter your HOME address. You should not enter your school address.
Street Address
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Phone
*
*Please be sure to add your mobile number. We will only be using this to connect with you during the event and if additional support is needed.
Email
*
School Staff Type
*
-- Select Staff Type --
Administrator
Counselor
Teacher
Other
T-Shirt Size
*
Select a Size
S
M
L
XL
XXL
XXXL
Professional Personal Identification Number (PPID) for ACT 48 Hours
*
Please provide your identification number given by PA DOE. Find your PPID HERE - https://www.perms.pa.gov/Screens/wfProfessionalPersonnelID.aspx .
If you DON'T have a PPID, please enter 0.
PPID's will ONLY be used for those who attend the SLT mock breakout.
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Comments
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