Your LDC or private training company's name (please include URL to website, if applicable) *
Your answer
If additional trainers are facilitating Ekman workshops in your group, please name them below.
Your answer
When did you become a PEI trainer? *
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Do you have an active license? *
If active, when does your license expire?
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When was your last license payment made? *
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YYYY
Do you need certificates? *
Did you successfully complete the TTT (Train the Trainer) program? *
If yes to TTT, when were you certified?
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DD
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What language(s) are you authorized to deliver trainings in?
Your answer
Did you pay for the trainings to be professionally translated? *
Which location(s) did you deliver workshops in? *
Your answer
Describe how you used/intend to use Ekman-copyrighted materials in your trainings *
Your answer
Are you interested in a license partnership with PEG? *
Are you willing to share your licensing contracts, fees, terms and other information with us? *
Are you interested in having your contact information added to a community "trainer directory"? *
If you are an Associate trainer, are you willing to up-train to become a Trainer? *
As a Trainer, what is your target client population? *
Your answer
Please outline immediate impediments preventing your success as a Trainer. *
Your answer
Preferred means of course facilitation: *
Required
Do you have additional professional qualifications and/or certification that could be used to upgrade the workshop course content/delivery? If so, please list and briefly describe curriculum *
Your answer
Additional comments
Your answer
A copy of your responses will be emailed to the address you provided.