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1. Agency Name: (Required.)

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2. Contact Name: (Required.)

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3. Title: (Required.)

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4. Address: (Required.)

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5. Email: (Required.)

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6. Phone #: (Required.)

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7. Requested Training Date & Time: (Required.)

Thank you for inquiring about our Cultural Awareness and/or Historical and Intergenerational Training. Please answer the following questions so we may tailor the training to your Agency’s needs.

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8. Which training are you requesting: (Required.)

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9. What is the duration of time requested? (Please note that we do NOT recommend anything less than 1 hour) (Required.)

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10. What services does your agency provide and who do you serve? (Required.)

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11. Who is the audience participating in the training session? (Required.)

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12. How many participants are you expecting to attend? (Required.)

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13. Do you prefer an in-person or virtual training? If in-person, where will the training take place (include address and contact number if different from above)? (Required.)

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14. If you prefer a virtual training, please indicate the platform you would prefer:

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15. On a scale from 1 (no knowledge) to 10 (expert), how would you rate the participants’ level of knowledge of American Indian Culture? (Required.)

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16. What outcomes do you want your participants to realize through the training? (Required.)

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17. Are there specific topics that you want to have addressed in the training? (Required.)

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18. Will a certificate of participation be needed? (Required.)

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19. Will you be able to provide a projector, internet access and, if needed, a microphone? (Required.)

We request that a donation be made to the Phoenix Indian Center for the Cultural Awareness and/or Historical and Inter-generational Trauma Workshops. If you would like a specialized training, please contact LanguageCulture@phxindcenter.org or egoodsoldier@phxindcenter.org to discuss costs.

For more information, you may contact:

Elicia Goodsoldier, Language and Culture Program Manager
egoodsoldier@phxindcenter.org or LanguageCulture@phxindcenter.org
Phoenix Indian Center
(602) 264-6768 ext. 118

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