Request edit access
Training, Workshop & Speaker Requests
Email address *
Contact Name & Title *
Your answer
Pronouns (Check all/any that apply)
Phone Number
Your answer
Organization/Business *
Your answer
Type of Organization/Business *
Required
Please choose the nature of the request *
Required
Event Address (Please provide any parking info/ directions as well) *
Your answer
Event Date(s) If unknown TBD *
Your answer
Time(s) (Include special directions i.e. multiple workshops) If unknown, enter TBD *
Your answer
Anticipated Number of Participants *
Your answer
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.)
Your answer
Reason for Request (Include any relevant events leading up to Request)
Your answer
How did you hear about Dr. Tyree Oredein's services?
Your answer
Which workshop topics are you requesting? *
Required
Please provide at least two (2) learning objectives you have for participants
Your answer
If you have not been quoted a fee, please enter TBD and you will be contacted to discuss price *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy