PLT-Ohio Facilitator Training Registration

Please complete the following questions to apply for PLT-Ohio's 2019 Facilitator Leadership Training. Registration is complete once this survey is submitted, payment is received, AND registration is confirmed with Samantha Clyde of Stark County Parks, (330)409-8997. Thank you!

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* 1. Please enter your contact information below.

Name:

Email:

Phone:

Mailing Address (Street, City, Zip):

Ohio County:

Position:

Affiliation (School, Agency, Organization, etc):

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* 2. What is your background (professional, personal, environmental education)?

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* 3. Annual outreach

Number of adults reached annually:

Number of youth reached annually:

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* 4. Why are you a good fit to be a PLT facilitator?

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* 5. Where would you plan to lead your first PLT professional development workshop? Who might your audience be?

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* 6. It is expected of PLT facilitators to co-lead a minimum of one workshop per year. How can PLT-Ohio help you meet this expectation?

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* 7. Do you need any special accommodations for the facilitator training workshop? (mobility, diet, etc.)

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* 8. To complete registration for Project Learning Tree-Ohio's 2019 Facilitator Training, the following must be completed within a week of submitting this survey. I agree to:

Submit payment of $75 to PLT-Ohio at 2045 Morse Rd. Bldg H-1 Columbus, OH 43229

Call Samantha Clyde of Stark County Parks to confirm registration (330)409-8997