Training Request Form
Please fill out the following information so that we can get back to you in a timely manner!
Primary Contact Name
City, State and Zip Code
How did you hear about us?
Who approved the program?
What motivated you to have this Professional Development/Training Program?
Professional Development/Training Program Variables
The school is an
check all that apply
The school is
The program is
Small (under 20)
The setting is
Professional Development/Training Program Logistics
Date of Program
Time of Program
(from ___ am/pm to ___ am/pm)
Location of Program
Directions to Program
Parking for program (if applicable)
Physical Set-up of Program Space
A/V Equipment Available
DVD Player/VCR/ TV
Will food or snacks be provided for the program?
Can Handouts be reproduced?
Yes (If Yes, When are they needed? Answer Below under "other")
Professional Development/Training Content and Audience
Title of Program
Purpose of Program
Topics to be Covered
Number of Participants
School History/Climate regarding LGBT Issues
Fees and Trainers
Fees can be Negotiated or Donated depending on need of Client. Full-Day: (4.5 hours or more) $2,000-$2,500 Half-Day: (1.5 to 4 hours) $1,400-$1,800 Other (Under 1.5 hours) $750-$1,000
Are Expenses Covered?
If Expenses are Covered, What is the budget, etc?
If Expenses are NOT Covered, What Non-Monetary items could be covered?
Never submit passwords through Google Forms.
Terms of Service