Capital Region ESD 113 Teaching and Learning Request Form
Capital Region ESD 113 Teaching and Learning Department is happy to support you in your district and building's planning needs. Our desire is to support you in as many of your student learning areas as possible. Below is a form that will inform our planning team in the types of Professional Development your district or building may need.

A representative from the Teaching and Learning Department will be in touch to support you in your needs. Please know some requests are more challenging to support than others. For most trainings a fee service agreement will need to be created to support the work. You will be contacted by our office to set up these arrangements.

Please contact Russ Rice, Director of Teaching and Learning at 360-464-6733 or or Lynne Forbush at 360-464-6783 or if you have any questions.

Email address *
Your Role *
Your answer
Your Name *
Your answer
School District *
Your answer
School Building
Your answer
Dates and times requested? *
Your answer
What subject(s)? *
Learning Objectives *
Your answer
Description of needs (where presented, tech needs, special considerations for presenter)
Your answer
How many participants? *
Your answer
Requesting clock hours? *
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