Online Request Form

 

Requestor Information

Address:*
Alternate Contact:*

Training Event Information

Date/Time:
:  
Location:*

We regret that due to staffing shortages we can only provide trainings to groups of 10 or more individuals.

Do you intend to make this training mandatory for your staff?
Would you be willing to open up this training to other interested agencies and organizations in your area?

Logistical information

Does the training room have a high speed internet connection available for use by trainers?*
Does the training room have a working external telephone?*
Do you have a video conference setup available for possible remote training?*
Are there elevators and/or ramps leading to the training room?*
Can you provide us with a screen?*
Can you provide us with electricity and an extension cord?*

Review Your Information

Requestor Information

Requestor Name:  {$26109381 Name:} 

Position Title: {$26109384 Position Title:}
Organization: {$26109388 Organization:}
Address: {$26109434 Address:}

Telephone: {$26109445 Telephone:}
Fax: {$26109447 Fax:}
Email: {$26109449 Email:}
Alternative Contact? {$26112027 Alternate Contact:}
Alternate Telephone: {$26112284 Alternate Phone:}


Training Event Information

Requested Topic:   {$26112581 Requested Topic:} 
Type of Presentation: {$26130551 Type of Event:}
If other, what? {$26115248 If other, enter:}
Purpose of Event: {$26115275 Purpose of Event:}
Date and Time: {$26117008 Date/Time:}
Length of training/event: {$26117014 Length of Training/Event:}

Floor: {$26129787 Floor:}
Room: {$26129792 Room:}

Location: {$26117067 Location:}

Telephone: {$26117071 Phone:}

Target Audience: {$26117135 Target Audience:}

If other, what? {$26117182 If other, enter:}

Number of Attendees: {$26117263 Number of Attendees:}

Do you intend to make this training mandatory for your staff? {$26117282 Do you intend to make this training mandatory...}

Would you be willing to open up this training to other interested agencies and organizations in your area? {$26117286 Would you be willing to open up this training...}


Logistical information

Does the training room have a high speed internet connection available for use by trainers?  {$26129685 Does the training room have a high speed...} 

Does the training room have a working external telephone? {$26129689 Does the training room have a working external...}
Do you have a video conference setup available for possible remote training? {$26129691 Do you have a video conference setup available...}
Are there elevators and/or ramps leading to the training room? {$26129696 Are there elevators and/or ramps leading to the...}
Can you provide us with a screen? {$26129701 Can you provide us with a screen?}
Can you provide us with electricity and an extension cord? {$26129707 Can you provide us with electricity and an...}
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