Request edit access
Training, Workshop & Speaker Requests
Sign in to Google to save your progress. Learn more
Email *
Contact Name & Title *
Pronouns (Check all/any that apply)
Phone Number
Organization/Business *
Type of Organization/Business *
Please choose the nature of the request *
Event Address (If online, indicate platform- Zoom, GoToMeeting, etc ) *
Organization/Business Address (if different from Event Address)
Event Date(s) If unknown TBD *
Time(s) (Include special directions i.e. multiple workshops) If unknown, enter TBD *
Anticipated Number of Participants *
Describe Participants (For staff, please include educational attainment and professional positions and populations served. For all others, please include age, ethnicity, and other socio-demographic descriptives.)
Reason for Request (Include any relevant events leading up to Request)
How did you hear about Left Turn Village? (Include names of anyone who referred you)
Which workshop topics are you requesting? *
Please provide at least two (2) learning objectives you have for participants
If you have been quoted a fee, please enter it here. If not, please enter TBD. *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy