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Training Request Form
Fill out this form to request a training or consultation from the Washburn Training Institute.
1.
Contact Information
Name
Organization
City
State
Email Address
Phone Number
2.
How did you hear about us?
Attended a previous training hosted by the Washburn Training Institute
Website (washburn.org or washburntraininginstitute.org)
Training Institute mailing list
Referral
Other (please specify)
3.
Training Topic
Child Development
Developmental Repair
PracticeWise
TF-CBT
Therapeutic Language
Other (please specify)
4.
Training Information
Desired length of training
Date preference
Time preference (if known)
Anticipated # participants
Please describe the audience
Desired trainer (if no preference, please leave blank)
Training Location
The United Health Foundation Training Institute at Washburn Center for Children is located in Minneapolis, Minnesota at 1100 Glenwood Avenue. Our training facility can accommodate up to 140 peopl
e.
5.
Are you interested in having Washburn host your training?
Yes
No
If no, please specify where you would like the training to be held:
For training and consultation rates, please contact traininginstitute@washburn.org
