BYE Interest and Raffle Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. – Step 1 of 2We are excited to connect with you about your interest. If you are interested in receiving mental health services through our partnership with BetterHelp, please follow this link> Please email info@byeinstitute.org if you have any questions or require assistance with this form. What services or training or you interested in (select all that apply)? *Empact FellowshipTeen Mental Health First Aid CertificationFirst Aid CertificationPREP Education ProgramYouth Peer Support GroupRaffle OnlyPlease list areas of support you are interested in *Tell Us More About YouName *FirstLastAgeGrade/Year in SchoolEmail *Phone Number *How did you learn about us? *EventFriendColleagueParentTeacherSchool Guidance CounselorSchool Resource CoordinatorPrincipal or Assistance PrincipalOther Youth OrganizationGoogleSocial MediaOtherPlease tell us how you learned about us. *NextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit
