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* 1. Timeframe of your event
**Please allow 15 working days from the time of your request 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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* 2. Your Name:

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* 3. Agency

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* 4. Phone Number:

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* 5. Email Address

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

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

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* 8. What class are you requesting?

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

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

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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?

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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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