User Registration

Username/Email

The password must have at least 8 characters, at least 1 number(s), at least 1 lower case letter(s), at least 1 upper case letter(s), at least 1 special character(s) such as *, -, or #

Password

Email Address

Re-enter Email

First Name

Last Name

City/Town

Country

The Prevention Learning Portal is affiliated with multiple states and educational partners. If you belong to one of these groups, please select it and you will work within that group's state-specific learning management system. If you do not know, please choose the "Pennsylvania Prevention Learning Portal" for the full catalog of prevention learning eCourses, which can be used by any learner in PA and beyond.

What is the zip code of your principal employment setting or school (if you are a student)? Please input your 5-digit zip code.

What is the name of your organization?

What is your primary occupation/profession (select one)?

If you selected "Other" as your primary profession, please specify your profession title here.

If you are a student, what is your primary field of study?

What is the highest degree you have received? (select one)

What is your System and/or Sector Classification? Choose one that best applies.

Which of the following best describes your principal employment setting? (select one)

If you chose "Other" for your Principal Employment Setting, please specify here.

How many years have you been active in the field of prevention?

Please select the best category that describes your workplace?

If you chose “Multiple categories listed above”, please provide which categories best describe your workplace using the numbers provided for each choice, separated by a comma. (For example, if you want to choose both 1 for Metropolitan and 2 for Tribal, type in “1, 2”)

What is your race?

If you answered “Other”, please specify here.

If you answered “Multiracial”, please provide which races you identify as by listing the corresponding numbers, separated by commas. (For example, if you want to choose both 3 for American Indian and 6 for Chinese, type in “3, 6”)

Are you Hispanic, Latino/a, or Spanish origin?

If you selected “Yes” for Hispanic, Latino/a, or Spanish origin, what ethnic group do you consider yourself?

If you answered “Other”, please specify here.

If you answered “Multiethnic”, please provide which ethnic groups you identify as by listing the corresponding numbers, separated by commas. (For example, if you want to choose both 2 for Cuban and 3 for Dominican, type in “2, 3”)

What do you consider yourself to be?

If you chose "Other," please specify here.

Do you think of yourself as?

If you chose "Other," please specify here.

Are you here for continuing education credits?

What Continuing Education or CEU credentialing bodies do you report to?

If you answered “Other”, please specify here.

If you answered, “Multiple”, please provide which credentialing bodies you report to by listing the corresponding numbers, separated by commas. (For example, if you want to choose both 1 for Act 48 and 4 for Social Work CEUs, type in “1, 4”)

Do you require Act 48 credits?

If you answered "Yes," what is your seven-digit PPID number? (Please note that no credits will be submitted on your behalf if you do not include your PPID number.)

Please confirm your seven-digit PPID Number.

Do we have your permission to release your information to the Pennsylvania Department of Education?

Security question

Required

Work Information

Demographic Information

Credentialing Information