Applied Suicide Intervention Skills Training (ASIST)

Dates: February 22/23 (Wednesday/Thursday)
Duration: 2 full days; 8:30 am to 5 pm
Community: Iqaluit
Training Location: Nunavut Arctic College -- Nunatta Campus
Language of Instruction: English
Instructors: Dawn Stewart, Jack Hicks and Sunday Thomas

Contact: Jack Hicks -- jhicks@arcticcollege.ca / phone 979-7298 / fax 979-7109

Registration: Seats are limited, and will be allocated on a ‘first come, first served’ basis. There is a $50 fee to cover the cost of materials and refreshments. If you are a GN employee, you need to have your supervisor sign the attached application/consent form. Your department or agency will be billed for your fee. If you work for a municipal government or an Inuit organization, you also need to have your supervisor sign the attached application/consent form. Your employer will be billed for your fee. Anyone else is very welcome to apply for the course, and must submit a cheque for $50 in addition to their completed application form.

Send to: Jack Hicks, jhicks@arcticcollege.ca / phone 979-7298 / fax 979-7109

APPLICATION FORM
Applied Suicide Intervention Skills Training (ASIST)
Iqaluit – February 22/23, 2012
I wish to take the Applied Suicide Intervention Skills Training (ASIST) workshop being offered by Nunavut Arctic College on October 3/4, 2011. I understand that participation in the full two days is required. I commit to showing up on time at 8:30 each morning.
Name (print): __________________________________
E-Mail: __________________________________
Home phone: _____________________ Work phone: ______________________
Employees of GN departments/agencies, Inuit organizations or municipal governments must have this section signed off by their supervisor:
I am the supervisor of this course applicant. I agree to this employee taking the ASIST workshop on the dates specified. I am aware that my division/organization will be billed $50 upon receipt of this form. I am aware that this amount will not be refunded if the applicant withdraws from the course, or if he/she fails to attend.
Name (print): __________________________________
Position: _________________________________________________________
Signature: _________________________________________________________
Name of departmental finance person to whom the invoice should be sent:
_________________________________________________________