APPLICATION TO TRAIN AS A

MENTAL HEALTH FIRST AID (SINGAPORE) INSTRUCTOR

APPLICANT’S NAME / Mr/Ms/Mdm/Dr / Surname / Given Name
CURRENT POSITION / Title:
ORGANISATION
NAME &
ADDRESS / Name:
Address:
CONTACT NO. / Office / Mobile / Home
HOME ADDRESS / Postal Code ( )
EMAIL ADDRESS / Main / Second address (if any)
COURSE: MHFA (SINGAPORE) INSTRUCTOR TRAINING COURSE (3 DAYS)

Mental Health First Aid (Singapore) course is designed for lay people who may not have any prior knowledge of mental health problems. We are interested in your experiences and skills that would enable you to teach this course.

Please answer the following questions in order to assist us to assess how you meet the section criteria. When writing your responses, please include specific examples of what you have done. Do attach your own additional pages if the space provided is insufficient.

1 / What are your personal and/or professional experience in mental disorders and their treatment, including any relevant qualifications? Your answer needs to demonstrate that you have good knowledge of mental disorders, their treatments and mental health and community services.
2 / What are your experience/qualifications that would enable you to conduct training sessions effectively? Your answer needs to demonstrate that you have good teaching, communication and interpersonal skills
3 / Please state 3 reasons for wanting to be a MHFA (S) instructor?
4 / In your opinion, what are the key skills needed to be an effective MHFA (S) instructor?
5 / Give 2 examples in which you have personally applied MHFA Action Steps. (use additional pieces of paper if necessary)
6 / What experience do you have to effectively network with a particular community or general community?
7 / Are you attached to an organization that will support you in some ongoing way as a MHFA (S) instructor? If so, please elaborate how you will be supported.
8 / Are there any group(s) of people to whom you are particularly suited to deliver MHFA (S) courses? If so, how would you organize and conduct the MHFA (S) course to this group?
9 / What do you think are the factors that lead to the stigma of mental disorders among general public?
10 / What would you do if one of your participants in the MHFA (S) session that you are conducting becomes distressed and approaches you about their mental health problems?

Please provide the contacts of two persons that we can get in touch with for your professional and character reference. One of the persons should have worked with you for at least a year on a professional level. Please provide valid contacts and ensure that the individuals are aware that we might call them up for reference. If the contacts are not valid (e.g. wrong numbers, person refusing to be reference contact for you), MHF-S reserves the right to reject your application.

Person A: / Person B:
Name:
Hand phone#:
Relationship
to you:
No of years that you know him/her:
Designation/ Company:

______

I agree that should I be accepted into the MHFA Singapore Instructor training, I will abide by the training schedule and requirements of the training course and accept that the decision of the trainers on the evaluation outcome as final.

Once accredited as an MHFA Singapore Instructor, I will conduct at least TWO MHFA (S) courses within a period of TWO calendar years in order to keep my accredited MHFA Instructor status active. I also agree to abide by the rules and regulations of MHFA Singapore and to maintain program fidelity and preserve the integrity of all copyrighted materials.

______

Signature of Applicant Date

MHFA(S) TTI Application Form (2018) Page 1 of 6