Training Request Form
Thank you for your interest in receiving an LGBTQ+ cultural competency training from the Pride Center. Please complete the form below. We will follow up with requests in the order in which they are received.
Organization:
*
Main Contact:
*
First Name
Last Name
Which of the following best describes your business/organization:
*
Please Select
Medical Services
Social/Human Services
Law Enforcement
Education (k-12)
College/University
Senior Services
Other
Are you a for-profit or non-profit organization?
*
For-Profit
Non-Profit
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
What length of time can your staff commit to for training?
*
1 hour
2 hours
3 hours
Other
What method of service delivery works best for your staff?
*
Virtual
In-person
Hybrid (some participants in room with facilitator; others joining online)
Approximately how many people do you anticipate participating in the training?
*
Please Select
Less than 10
10-20
21-49
50-75
76-99
100-150
150+
What level of staff will be trained? (Check all that apply)
*
Direct Care Staff
Administrative/Reception
Management
Executive/Board of Directors
Interns/Students
Other
Are you looking for this training to contribute to Continuing Education Units (CEUs) for any of the following professional licenses: LMHC, LCSW, LMSW, LCSW-R, CASAC?
*
Yes
No
Unsure
What are some days/times when you would be available for a phone call or Zoom meeting to discuss your request?
*
Is there anything specific that you would like to have included in the training?
Submit
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