Be-PrEPared Schedule a Training Form
Please complete this form to Schedule a "Be PrEPared!" training
Name
Your answer
Date Request Submitted
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Email Address
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Phone Number
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Agency/Organization/Program Name
Your answer
Each training is scheduled in 3-hour blocks and the training schedule is based on dates of availability. Please identify at least 2 possible dates and times for the training. The training should be scheduled at least 2-3 weeks in advance.
1st Training Date & Time Preference
Your answer
2nd Training Date & Time Preference
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3rd Training Date & Time Preference
Your answer
Please provide information on where the training will take place.
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Does the training location have internet access?
How many people are expected to attend the training?
In the space below, please provide any additional information to take into consideration.
Your answer
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