Customer Service Certification Session Request

Please complete and submit the following:

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* 1. Teacher/organizer's name

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* 2. Phone number with ext.

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* 3. Email address of teacher contact

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* 4. What school will the CSC session be held in?

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* 5. What date and time would you like your CSC session delivered?
_{Please note that AM/PM sessions MUST be scheduled on the same day. (i.e. we do not split sessions between two or more different days)}

Date / Time AM Session

Date

Time

AM/PM

Date / Time PM Session

Date

Time

AM/PM

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* 6. What is the estimated number of students participating in the AM session?
_{Sessions are limited to 30 students}

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* 7. What is the estimated number of students participating in the PM session?
_{Sessions are limited to 30 students}

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* 8. What room will the CSC session be held?

Library

Learning Commons

Other (please specify)

^{THANK YOU}

^{Our Program Manager will contact you to confirm your CSC Training.}