Training Request Form
In submission of this form, your must agree to the following:
- Submit Training Request Form at least 2 weeks prior to requested training date
- Contact EPICS staff within 24 hours of scheduled training date/time if there is a need to cancel or reschedule
- Advertise the event to reach at least 10 attendees
- Collaborate with EPICS staff in planning the logistics of the training room (room arrangements, AV, etc.)
- Make copies of handouts submitted by EPICS for Training Participants

For Questions, contact us at (505) 767-6630 or kwoody@epicsnm.org

Email address *
Name of Agency *
Your answer
Name of Contact Person *
Your answer
Phone Number *
Your answer
Email *
Your answer
Training Information
Proposed Date *
MM
/
DD
/
YYYY
Proposed Time *
Time
:
Proposed Location *
Your answer
Estimated Number of Participants *
Your answer
Types of Participants *
Required
Workshop Requested: *
Submit
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