Building Resilient Teams Application

Thank you for your interest in Building Resilient Teams, an online discussion group designed to explore the impact of secondary traumatic stress and to build resiliency within your MDT.

Up to 24 teams of 2 representatives from a single MDT will be selected to participate in each cohort. Please keep in mind that at least one individual from each team should serve in an MDT leadership role, such as MDT coordinator/facilitator, Executive Director, or Program Manager.

Each individual from your 2-person team must fill out this application. You will be asked who will be applying with you from your MDT (to help us match you to your team member). Your team application is not complete until BOTH team members have completed and submitted an application.

1. Contact Information

First Name *This question is required.

Middle Name

Last Name *This question is required.

Organization/Agency *This question is required.

Job Title *This question is required.

Phone Please enter as 10 digits with no formatting (e.g., 8589661700). This question requires a valid number format.

Phone Type

Email Address *This question is required. All correspondence for the discussion group will use this e-mail address. This question requires a valid email address.

Organization/Agency Address *This question is required.

City *This question is required.

Zip *This question is required.

Name of Affiliated Children's Advocacy Center or MDT *This question is required.

2. Do you have a leadership role on your MDT? *This question is required.

If yes, what is your role on MDT? (Example: Coordinator, Facilitator, Member, etc.) *This question is required.

3. What is the name of the team member who will attend this training with you? *This question is required. Your team application is not complete until BOTH team members have completed and submitted an application.

4. Does this team member have a leadership role on your MDT? *This question is required.

If yes, what is this team member's role on the MDT? (Example: Coordinator, Facilitator, Member, etc.) *This question is required.

5. What is your team member's email address? *This question is required. They will receive an email notification that you have submitted your application. This question requires a valid email address.

6. How often do you participate in MDT case review meetings? *This question is required.

7. Have you received any previous training in resiliency or vicarious trauma/secondary traumatic stress? *This question is required.

8. What do you hope to walk away with from your participation in this discussion series?

9. Additional Comments

10. Would you like to join our mailing list to receive occasional email alerts about training opportunities and resources?

11. STAY CONNECTED: Would you like to share your contact information with other participants of this cohort?