Extension Workshop Request Form for Tribes and Villages
Interested in having a fun, hands-on, research-based workshop in your village or a virtual workshop? Then Please complete the form below. 
Sign in to Google to save your progress. Learn more
Email *
Please select no more than three workshops that your community is interested in. *
If you don't see it listed here, you can write it in the "other" category.
Required
Is there a Traditional Knowledge Holder in your community (or outside) that you think would be interested in co-presenting with us? What is their contact information? What is their knowledge area?
Would you like a virtual or in-person workshop? *
Virtual workshops are offered using Zoom and requires Internet connectivity
If Face-to-Face workshop is requested, is the Tribe able to assist with travel costs including airfare, lodging, and transportation? (Due to budget cuts, we have less funding for travel than we had before) *
Tribe or Village *
Are there at least 5-10 people interested in this workshop? *
Name *
Job Title
Email *
Phone Number *
Mailing address (Supplies will be freighted ahead to this address) *
When would you like to schedule a workshop? *
Please list three possible dates to hold a workshop, in order of preference.
Where would a good location to hold the workshop? *
Ex: School, Tribal Office, Community Center
Where is a good place for the instructor to stay? *
Will someone be available to transport the instructor and workshop supplies from the airstrip to town? *
Please specify who can transport the instructor to and from town.
Is someone willing to advertise the program around town? If so, who? *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of UA.