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Training Program Registration
Please fill in all fields to ensure registration. Complete mailing address (e.g., floor, department, etc.) is needed to ensure Confirmation Letters reach you!

First Name
Last Name
MI
*Primary Work Setting (Please choose only one)
*Primary Occupation (Please choose only one)
Years in Current Occupation:
*Ethnicity (Please choose only one)
Hispanic or Latino
Non Hispanic and Non Latino
*Race (Please pick all that apply)
White
Black or African American
American Indian or Alaskan Native
Asian
Native Hawaiian or Other Pacific Islander
More than one race
Unknown/unreported
*Education Level
(Please pick the highest educational level completed)
Agency
Agency Address
City
State
Zip
Daytime Phone
Fax
Email Address
County most worked in
Mailing Address (if different from above)
City
State
Zip

Please indicate any accommodations needed (e.g. sign language, interpreter, large print materials, etc.):

Have you registered for trainings with us before?

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Select Your Courses
Addressing Prevention in HIV-Positive Clients
(9am-5pm)
December 2, 2009 (Hawthorne)
Addressing Sexual Risk with Druf Users and Their Partners
(9am-5pm)
August 5, 2009 (Hawthorne)
November 24, 2009 (Newburgh)
Basic Information About Domestic Violence
(9am-5pm)

June 11, 2009 (Hawthorne)

Building Bridges to Cultural Competency
(9am-5pm)

July 14, 2009 (Hawthorne)

Community HIV/AIDS Educator Training (4-day Training)
(9am-5pm)

September 14, 15, 21 & 22, 2009 (Hawthorne)

Domestic Violence in LGBT Communities
(9am-5pm)

October 29, 2009 (Hawthorne)

Enhancing the Partnership between Client & Case Manager
(9am-5pm)
May 19, 2009 (Hawthorne)
September 29, 2009 (Hawthorne)
Group Facilitation Skills for STD/HIV Prevention (2-day training)
(9am-5pm)

October 14 & 15, 2009 (Hawthorne)

HIV/AIDS Confidentiality Law
(1pm-4pm)

September 3, 2009 (Hawthorne)

HIV/AIDS Treatment Update
(1pm-4pm)
November 5, 2009 (Newburgh)
HIV/HCV Co-Infection
(9am-12pm)

June 17, 2009 (Hawthorne)

HIV and Hepatitis C Co-Infection
(1pm-4pm)

September 9, 2009 (Newburgh)
October 1, 2009 (Hawthorne)

HIV & STDs
(9am-5pm)

September 10, 2009 (Hawthorne)
HIV Disclosure: Deciding Whoe and When To Tell
(9am-5pm)

July 7, 2009 (Hawthorne)
November 17, 2009 (Newburgh)

HIV Testing in NYS: 2005 Guidance
(1pm-4pm)

August 19, 2009 (Hawthorne)
HIV Testing: Skills Practice Session
(9am-5pm)

August 20, 2009 (Hawthorne)

Introduction to Case Management
(9am-5pm)

September 28, 2009 (Hawthorne)

It's Time: Integrate Viral Hepatitis Into Your Work (2-day training)
(9am-5pm)

November 10 & 12, 2009 (Hawthorne)

Overview of HIV Infection & AIDS
(9am-5pm)

July 30, 2009 (Newburgh)

Practicing the NYS Domestic Violence Screening Protocol
 (9am-5pm)

August 26, 2009 (Hawthorne)

Promoting Adherence to HIV Treatment
(9am-5pm)

December 7, 2009 (Hawthorne)
Reducing the Risk & Harm of HIV
(3-day training)
(9am-5pm) 		October 20, 21 & 22, 2009 (Hawthorne)
Serving Families: From Assesment to Service Plans (2-day training)
(9am-5pm) 		October 5 & 6, 2009 (Hawthorne)
Sex, Gender and HIV/STDs
(2-day training)
(9am-5pm) 		June 23 & 24, 2009 (Hawthorne)
October 7 & 8, 2009 (Hawthorne)
December 9 & 10, 2009 (Newburgh)

Tailoring HIV Counseling and Testing to the Unique Needs of Adolescents
(9am-5pm)

July 21, 2009 (Hawthorne)

What's New in HIV/AIDS Update
(1pm-4pm)

October 27, 2009 (Hawthorne)

IMPORTANT! ** HIV Testing: 2005 Guidance & HIV Testing: Skills Practice Session requires supervisor’s justification of job responsibilities relevant to the course.
(Not required for physicians, dentists, or other clinicians.) The Supervisor must fax a note on letterhead stating
“[Your Name] currently is, or will be, responsible for providing HIV Testing as part of his/her job.”
to Fax: (914) 785-8331. This note must include the supervisor’s signature.
 
 
 
 
 
 

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