Your event date     Request deadline 
 January-May     November 15
 June – August     April 15
 September – December  
 July 15

Timeframe of your event
**Please allow 15 working days from the deadline for a reply. If we are not able to accommodate your request, we will do our best to suggest alternative resources.

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* 1. Timeframe of your event
**Please allow 15 working days from the deadline for a reply. If we are not able to accommodate your request, we will do our best to suggest alternative resources.

Your Name:

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* 2. Your Name:

Agency

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* 3. Agency

Phone Number:

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* 4. Phone Number:

Email Address

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* 5. Email Address

If known, what date(s) are you requesting?

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* 6. If known, what date(s) are you requesting?

Location of Training (City/Building):

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* 7. Location of Training (City/Building):

What class are you requesting?

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* 8. What class are you requesting?

Estimated number of employees? (Minimum of 15 participants)

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* 9. Estimated number of employees? (Minimum of 15 participants)

What is your desired outcome for this session? What do you hope we accomplish in our time together?

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* 10. What is your desired outcome for this session? What do you hope we accomplish in our time together?

How will you know if the training is successful? What behaviors or attitudes will you see in your staff or colleagues that demonstrates the training was effective?

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* 11. How will you know if the training is successful? What behaviors or attitudes will you see in your staff or colleagues that demonstrates the training was effective?

Any other information that helps us understand the situation and what you hope to get out of the training:

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* 12. Any other information that helps us understand the situation and what you hope to get out of the training:

Please allow 15 working days from the deadline for a reply. If we are not able to accommodate your request, we will do our best to suggest alternative resources.

Your event date    Request deadline
January-May    November 15
June – August     April 15
September – December    July 15

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