Www.namifoxvalley.org
323850668655Submit to: Lisa Schiller, Program AssistantEmail: lisa@, Fax: (920) 954-0490, or Mail: NAMI Fox Valley, 211 E. Franklin St., Appleton, WI 5491100Submit to: Lisa Schiller, Program AssistantEmail: lisa@, Fax: (920) 954-0490, or Mail: NAMI Fox Valley, 211 E. Franklin St., Appleton, WI 549116166485-55245Stipend Amount_____________________________________________00Stipend Amount_____________________________________________4604385-55245STAFF USE ONLY: NAMI Talks SPEAKERS / Presenters__________________________________________________________________________________________________________________________________________00STAFF USE ONLY: NAMI Talks SPEAKERS / Presenters__________________________________________________________________________________________________________________________________________3289935-55245STAFF USE ONLY (before event):___ Outreach form created___ Added to summary doc.___ Staff persons assigned___ Folder prepared___ NAMI resources in folder___ Equipment checkout___ Evaluation created/printed___ Invoices sent___ Room Reserved00STAFF USE ONLY (before event):___ Outreach form created___ Added to summary doc.___ Staff persons assigned___ Folder prepared___ NAMI resources in folder___ Equipment checkout___ Evaluation created/printed___ Invoices sent___ Room ReservedOutreach Request for Youth ProgramsContact InformationContact NameName of Organization Address of Event Telephone EmailDate of Event Start/End TimeDescribe Audience # of Participants Technology Available ___ Computer (With Internet Access) ___ SMART Board ___ Projection Screen ___ Projector ___ None Requested ProgramPlease select the type of program you are requesting for the school or organization. Descriptions for the programs are located on the next page. (The selections are in alphabetical order.)Student ProgramsAdult Programs? Mental Health Chat (30-45 min./elementary)? Compassion Resilience (time varies)? Ending the Silence (50 min./middle & high school)? Ending the Silence for Families (60-90 min.)? Youth Mental Illness 101 (50 min./high school)? Ending the Silence for School Staff (60-90 min.)Resource Table ? State time needed, including set-up time ___________________________? Customized Option—If you have a unique training need or might like us to combine some of the training topics to better meet your organization’s needs, please describe below or contact us.-19057874000Student/School ProgramsStudent ProgramsEnding the Silence for Students (50 minutes)—This presentation is for middle or high school students and provides information on the signs and symptoms of mental illness, helps teens learn mental health coping skills, reduces stigma through personal stories, and educates students on how to reach out for help for themselves or a friend.Mental Health Chat (30-45 minutes)—Mental Health Chat is a mental health awareness presentation targeted to 3rd-5th grade students. The presenter is someone living with a mental illness or someone who is a family member of someone living with a mental illness. Mental Health Chat includes an introduction to NAMI and a brief description of mental illness, reading a book about feelings/moods, an interactive activity on mental illness, and a relaxation exercise using GoNoodle.Youth Mental Illness 101 (50 minutes)—This presentation, designed for high school students, provides an overview of mental health challenges specific to teens, their incidence and biological basis, treatment and recovery, the adverse effect of stigma, and the importance of advocacy.Adult ProgramsCompassion Resilience (time varies)—This workshop offers information, resources and activities for organizational leadership and staffs to help them understand, recognize and minimize the experience of compassion fatigue, as well as to increase compassion resilience perspectives and skills. Please note: there will be a charge for this workshop.Ending the Silence for Families (60-90 minutes)—This presentation is for adults with school-aged children and includes information about the warning signs of mental illness, facts and statistics, how to talk with your child, and how to work with school staff to best support and advocate for your child.Ending the Silence for School Staff (60-90 minutes)—This presentation includes information about the warning signs of mental illness, facts and statistics, how to approach students, and how to work with families who may have a child facing mental health challenges.right2132330STAFF USE ONLY (after event):___ Summary received/added___ Outreach summary finalized___ Evaluations received___ Evaluation results compiled___ Payment received___ Donations recorded___ Stipends paid Request Totally ___ Completed00STAFF USE ONLY (after event):___ Summary received/added___ Outreach summary finalized___ Evaluations received___ Evaluation results compiled___ Payment received___ Donations recorded___ Stipends paid Request Totally ___ Completed ................
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