Custom Workshop Request | Training for Change Powerbase

Thanks for submitting a Custom Workshop Request. If you'd rather request a Custom Workshop over the phone, click here to schedule a phone call.

Your Contact Information

First Name *

Last Name *

Phone Number *

Email *

Your title or role in your group/organization

Organization/Group Information

Organization/Group Name *

City

State/Province

Country

What best describes your organization/group? Choose all that apply. *

What does your organizaton/group focus on? Choose all that apply.

What best describes the racial/ethnic background of your organization's/group's constituency?

What best describes the class background of your organization's/group's constituency?

Number of Staff/Leaders

Number of Members

Organization/Group Website (link)

Phone Number (if different from above)

Email (if different from above)

Custom Workshop Request

What is the purpose or goal of your group/organization? What does your organization do? *

What kind of workshop are you looking for? *

What do you hope to accomplish by working with Training for Change? *

What months, days, or time of year might you want the work to happen? An estimate is okay. *

How many people will attend (an estimate is okay)? Who are they in the group? *

How much might you have available to financially contribute? (provide range or any other considerations) *

How did you hear about Training for Change *