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
Your Telephone Number
Please include the full name of the school, church, or community organization that will host this course.
Your Title/Position (at the school/organization)
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)
Will this class target any specific populations?
Spanish language speakers
Students with special needs
Adults with special needs
N/A or unsure
Who will be your Trainer(s)?
If you/your Trainer(s) have NOT taught a TGH CHA course before, please provide an email address for each person.
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)
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?
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This form was created inside of Tech Goes Home Chattanooga.