Workshop Request Form
Please complete all fields in the form below to request a workshop or presentation from CAASE's Prevention Education team. Incomplete forms will not be considered. Please refer to our Prevention Education page to find a detailed description of our curricula prior to requesting a specific workshop to ensure we're meeting the needs of your audience. Once your request has been received, the Prevention Education Manager will reach out to confirm details, or seek alternative arrangements should we be unable to accommodate your dates. Please email Shalini Mirpuri (smirpuri@caase.org) with any questions you may have.
Email address *
First and Last Name: *
Your answer
Email (most frequently used): *
Your answer
Phone Number: *
Your answer
Audience Description: *
Name of Organization or School Requesting: *
Your answer
Have you requested a workshop from CAASE before? If so, please provide details:
Your answer
If interested in a single-session workshop, please choose from the list below:
If interested in a multi-session workshop, please choose from the list below:
Desired Date of Workshop (for multi-sessions, select the desired date of first session): *
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DD
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YYYY
Desired Time of Workshop:
Time
:
Alternate Date of Workshop: *
MM
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DD
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YYYY
Alternate Time of Workshop:
Time
:
Preferred Location: *
Your answer
Expected Number of Attendees: *
Please provide us with any additional details (i.e. class schedules, specific needs of the audience, adjustments to objectives, etc.):
Your answer
Requests should be submitted at least one month in advance. Once your request has been received, CAASE will reach out via email to confirm specific details. Approved requests are limited to certain dates and times to maximize attendance, up to the discretion of CAASE. By checking the box below, you indicate that you understand and will abide by these terms. *
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