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New Training Request Form
Requestor and Project Information
Please complete all the fields on the project request form. The new project team meets monthly to review requests.
*
1.
Please enter the Requestor Information below.
(Required.)
Requestor Name
*
Company
*
Address
*
Address 2
*
City/Town
*
State/Province
*
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
*
Country
Email Address
*
Phone Number
*
2.
Who is the sponsor or advocate for this program?
3.
What is the topic of the training?
4.
Please enter a high level timed outline of the course topics.
5.
What is the target length of the training (hours, days)
6.
What will be the delivery method, check all that apply.
In Person
Online Live
Online Self-Paced
7.
If a Subject Matter Expert(s) has committed to assist with this project, list name(s) below.
8.
Will this training be based on supporting publications or existing materials?
Yes
No
If Yes, please list below.
9.
Are there any similar and/or existing ICC Training available?
Yes
No
If Yes, please note which training may be similar.
10.
Are there any competitive offerings (identical or similar, including Preferred Provider)
Yes
No
If yes, please note which training may be similar.
11.
What is the specific need and/or justification for this training? Select all that apply.
Financial
Strategic
Political
Required Update (Code Year or Other)
Chapter Request (CEB)
Code Adoption
Jurisdictional Customizations
Collaboration
Other (please specify)
12.
Who is the target audience?
13.
Approximately how many participants will there be?
14.
How many times will this training be offered?
1-5
6-10
Unlimited
Other (please specify)
15.
Is this training primarily to (please select all that apply):
Promote career advancement
Meet a licensing requirement
Advance personal growth
Prepare for an exam
If not listed above, please note here.
16.
When is the expected/requested launch date for this program?
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
17.
This training will be expected to (check all that apply)
Generate funds for ICC's mission
Recover its development costs
Fill a gap in our training offerings
Meet a public expectation
Create or promote adoptions
If other, please note here.