Host Training Request

1.Full Name:(Required.)
2.Your title(Required.)
3.School District/ Agency?(Required.)
4.E-mail Address:(Required.)
5.Contact Phone:
6.What month and year are you seeking to host this training?
7.If you know of a specific date(s) you'd like to host the training, please indicate that here.
8.Does your District / Agency have a dedicated training room that can accommodate at least 50 attendees comfortably?
9.Will you provide SSAC with the total number of individuals that that would attend this training, or would you prefer SSAC to handle registration online through our portal?
10.Please list the topics you'd like SSAC to bring to your area for in-service training: