Update your profile (for LivingWorks Trainers only)

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LivingWorks Education Inc., hereinafter referred to as “LivingWorks”, maintains a high level of security with respect to the confidentiality of your records, and complies with the provisions of the Privacy Act. We do not collect information that is extraneous to the efficient operation of LivingWorks, nor do we release information without your authorization. See LivingWorks’ Privacy Promise.

Personal information

LivingWorks will maintain your photograph (taken at your Training for Trainers course) and the information you provide in this section on file for the purpose of confirming your identity, recording training history and credits, collecting dissemination statistics, providing service and support, sending internal communications and mailing completion certificates. We can only use one address for these purposes; please indicate which address we should use: HOME WORK

Name in full:			Trainer ID#:

HOME
Mailing Address:			City:
Prov/State:			Postal/Zip Code:
Country:			E-mail:
Phone Number:			Fax Number:

WORK
Company/Organization:
Department:			Title/Job Position:
Mailing Address:			City:
Prov/State:			Postal/Zip Code:
Country:			E-mail:
Phone Number:			Fax Number:

In what other languages could you serve as a trainer?
If you have knowledge about or experience in working with special populations, please specify:

Authorization and Agreement

The network of trainers and session leaders registered with LivingWorks Education is a key source for sharing resources and supporting suicide-safer communities. Your contact information will be available to this network unless otherwise indicated here: Please do not release my contact information to other registered trainers and session leaders
With regard to the provisions of the Privacy Act, I hereby authorize LivingWorks to maintain my personal information on file for the purposes as stated above.
I agree to inform LivingWorks of any updates to my personal information.