Workshop/Training/Presentation Inquiry Form

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If requesting more than one workshop/training/presentation, please submit separate forms.

Your name or primary contact *

(First name, last name)

Name of organization or school *

Address of organization or school *

(i.e. 3600 W. 26th Street, Chicago IL 60623)

Phone number of primary contact *

i.e. (555) 555-5555

E-mail address of primary contact *

What type of workshop/training/presentation are you requesting? *

Navigating Deferred Action for Childhood Arrivals (DACA) and Other Forms of Relief

Everything you wanted to know about Common Core State Standards, but were afraid to ask.

Common Core Math: A focus on Kindergarten to 3rd grade with attention to English Learners

Advocating for Early Childhood Education

Fair Housing

Immigration

State Budget

Other:

Required

If you selected "Fair Housing," "Immigration," or "State Budget," please provide more details regarding your desired topic. *

Anticipated date for desired workshop/training/presentation?

(ie.March 15, 2016, Spring Semester, or TBD)

Please choose preferred language. *

English

Spanish

Both

Anticipated number of participants? *

(ie. 25 attendees)

Based on the number of participants, would you like the handouts to match the language of the presentation? *

Yes

Mixed

If you selected "Mixed" in the last question, please indicate the number of packets in each language?

(ie. English-5, Spanish-10)

Please check the category of participants that make up your group? *

(You may choose more than one category)

Parents

School Staff

School Administrators

Students

Organizational Staff

Community Residents

Other:

Required

If you selected students, please check the grade level that up your group of participants?

(You may choose more than one category)

Elementary

High School

College-Undergraduate

College-Graduate

Other:

Presentations may vary in length depending on content. Please check one of the following choices that match your needs.

1 hour

2 hours

3 hours

4 hours (Half Day)

Clear selection

Will you provide a location to host the workshop/training/presentation? *

Yes

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