Safe Place - 40-Hour Domestic Violence Training (In Person Registration and Payment)

40-Hour Training Registration

Name*
First Last
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Please tell us why you are interested in taking 40-hour domestic violence training.*
Please check the category that describes the reason you are taking the training.*
- Personal
- Volunteer/Intern
- Professional development
If you are coming here from an organization, please tell us which organization you work for.
Click here if you would like closed captioning on during the presentations.
- Yes, I would like closed captioning
Please list any accomodations you may need for the in-person training.
Have you ever been convicted of a violent crime?*
- Yes
- No
We ask this question to ensure the safety of domestic violence victims due to the nature of information shared at the training. You may be required to submit to a background check. A criminal conviction does not necessarily disqualify you from participating in the training - this is assessed on an individual basis.
If you answered yes to the above question, please list your conviction and date.
Have you received any DIRECT domestic violence services from A Safe Place or other social service agency in the past two years or are you receiving services currently?*
- Yes
- No
40-Hour Training Quantity
Price: $200.00
Waivers and discounts may be available for individuals under financial hardship. Please contact Aiyana at aemsun@asafeplaceforhelp.org or (847) 731-7165, ext. 1401 for an application and more information. Payment must be submitted to A Safe Place in order to begin the online modules.
Total
$0.00
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
CAPTCHA

Join us for our Sip & Support January 30, 2025

40-Hour Domestic Violence Training (In Person Registration and Payment)

About

40-Hour Training Registration