2020/2021 TGH CHA Course Request
Please note: completing this form does not guarantee your course will be approved. You will receive a separate email from us for each course session that has been approved.
If you have questions, contact Sammy Lowdermilk at
sammy@techgoeshomecha.org
.
* Required
Your Name
*
Your answer
Your Email
*
Your answer
Your Telephone Number
*
(xxx) xxx-xxxx
Your answer
Organization Name
*
Please include the full name of the school, church, or community organization that will host this course.
Your answer
Your Title/Position (at the school/organization)
*
Your answer
Which type of TGH CHA course would you like to offer?
*
School Program (K-12 student/caregiver pairs)
Early Childhood Development Program (Pre-K toddler/caregiver pairs)
Community Program (adult participants)
Community Program (school-aged child/caregiver pairs)
Small Business Program (adult participants)
Required
Will this class target any specific populations?
*
Spanish language speakers
Students with special needs
Adults with special needs
N/A or unsure
Other:
Who will be your Trainer(s)?
*
Your answer
If you/your Trainer(s) have NOT taught a TGH CHA course before, please provide an email address for each person.
Your answer
When would you like to offer a TGH CHA course at this site in 2020/21?
*
This will help us evaluate our distribution and we may be able to approve your site for a future session (if you are not approved for the next upcoming session).
Summer (June/July - September 2020)
Fall (August/September - December 2020)
Winter (January - March 2021)
Required
How will this class be conducted?
*
In-person at the school/organization
Virtually (via Zoom or other similar platform)
Hybrid or not yet sure
Anything else you would like us to know?
Your answer
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